COLUMBIA LIBRARIES OFFSITE HI Al I II '.'.II MM '. MA A ' HX64075079 RA787 K79 Industrial and perso ! ■ I • RIAL and PERSONAL RECAP HYGIENE )ty GEO. M. KOBER, M. D., LL. D. \ Columbia ?Hnfoerattp *°\ in tfje Cttp o! Jleto |9orfe College of ipfjpstcians anb g>urgeon$ Reference Htbrarp Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/industrialpersonOOkobe INDUSTRIAL AND PERSONAL HYGIENE BY GEORGE M. KOBER, M. D., LL.D. Chairman of the Committee on Social Betterment of the President's Homes Commission, Professor of Hygiene, School of Medicine, Georgetown University A REPORT OF THE COMMITTEE ON SOCIAL BETTERMENT PUBLISHED BY THE PRESIDENT'S HOMES COMMISSION WASHINGTON, D. C. 1908 The President's Homes Commission, Appointed by President Theodore Roosevelt President. General Geo. M. Sternberg Secretary George M. Kober Assistant Secretary H. C. Macatee Treasurer John B. Sleman, Jr. i»- Statistician Gustavus A. Weber Executive Secretary Charles F. Weller Executive Committee Geo. M. Sternberg, Chairman Geo. M. Kober Wm. H. Baldwin Frederick L. Siddons S. W. Woodward Miss Mabel T. Boardman Social Betterment Committee Geo. M. Kober, Chairman James B. Reynolds Wm. F. Downey Whitefield McKinlay Emmett L. Adams Mrs. Thomas T. Gaff Miss Mabel T. Boardman K^ ^ v TABLE OF CONTENTS. I'agc. PART [.—INDUSTRIAL HYGIENE 9 Introduction 9 Occupations and Mortality 10 Morbidity and Mortality of Wage-Earners 12 Indoor Occupations 15 Occupations Involving Exposure to Irritating Dust 16 Metallic and Mineral Dust 18 Vegetable Dust 22 Textile Industries 23 Animal Dust 28 Occupations Involving Exposure to Infective Matter in Dust 29 Rag, Paper, Wool and Hair Industry 29 Occupations Involving Exposure to Poisonous Dust — Lead Dust 31 The Lead Industry in Massachusetts 33 Printers, Type Founders and Typesetters 35 Arsenical Dust 39 Occupations Involving Exposure to Irritating or Poisonous Gases or Vapors. 40 Sulphur Dioxide 40 Hydrochloric Acid 41 Sulphuric and Nitric Acid 42 Ammonia 42 Chlorine Gas 43 Bleaching Establishments 43 Iodine and Bromine Vapors 43 Turpentine 44 Petroleum 44 Benzine Vapors 44 Carbon Monoxide 45 Carbonic Acid Gas 45 Carbon Disulphide 45 Naphtha 46 Nitrobenzol 46 Dyeing and Cleansing 46 Rubber Industry 47 Patent Leather Industry 47 IV. Page. Aniline Vapor 47 Wood Alcohol 48 Chrome Pigments 49 Quinine 49 Manganese 49 Brass Founders 49 Arsenical Fumes 5° Mercury 5° Phosphorus 5 1 Beet-Sugar Industry 5 2 Occupations Involving Exposure to Extremes of Heat, Sudden Changes, and Abnormal Atmospheric Pressure 5 2 Caisson Disease 53 Occupations Involving Constrained Attitudes 54 Occupations Involving Over Exercise of Parts of the Body 54 Occupations Involving Exposure to Machinery, etc 55 Coal Mining 56 Railway Service 59 Railway Accidents 60 Accidents and Injuries 61 Occupations Involving the Inhalation of Organic Gases and Vapors 63 Employment of Women and Children 64 Infant Mortality in Relation to the Occupation of Women . . . .* 68 Special Measures for the Prevention of Tuberculosis Among Wage-Earners. 71 Measures for the Protection of Wage-Earners 72 Sanitation of Workshops and Quarters for Employees 73 Cubic Air-Space and Amount of Fresh Air per Hour 74 Ventilation 75 Temperature 78 Humidity of the Air 79 Lighting 80 Artificial Light 81 Prevention of Accidents ". 82 Miscellaneous Sanitary Provisions 83 Lodging Houses and Sleeping Quarters 85 Permanent Expositions Devoted to Industrial and Social Betterment of Wage-Earners 85 What the Federal Government May Do for the Promotion of the Welfare of its Employees 86 German Workingmen's Insurance System 87 What the Employer May Do for the Welfare of Employees 93 What the General Public May Do 95 What the Employee May Do to Contribute to His Own Welfare 101 PART II— PERSONAL HYGIENE 101 Care of Special Organs or Parts of the Body 113 Appendix A — Health of Employees in the Government Printing Office, Washington 116 APPENDIX.— REGULATION OF DANGEROUS TRADES IN ENG- LAND 125 Washington, D. C. February /\, kjoH. To General George M. Sternberg, Surgeon-General U. S. A. (Retired), Chairman of the President's Homes Commission, Washington, D. C. Sir — The Committee on Social Betterment finds it difficult, if not impossible, to elaborate plans for the amelioration of present standards of living among the least resourceful people without a full considera- tion of the relations of certain occupations to the health of those engaged therein. The question of health is intimately connected with the physical, social and moral welfare of the human race and plays an important role in the prosperity of countless numbers of our fellow beings, whose only income is the product of their daily labor. It will be readily conceded that health is the chief asset of the workingman, and that no greater calamity can befall him than when his earning capacity is impaired, or arrested, by reason of sickness or disability. It means, in many instances, the utter financial ruin of the family and is doubtless one of the most potent causes of want and poverty. The truth of this statement is being more and more appreciated, and well directed efforts are being made everywhere to prevent, as far as possible, the fundamental causes of poverty and distress. In this the medical profession has been a helpmate to religion. Men who come in daily contact with sickness and distress can not fail to experience deep sympathy for their fellow men, which is all the more profound when they realize that many of the diseases are preventable, and much of this terrible suffering cruelly unnecessary. These tender feelings inspired by a desire to render a service to humanity have stimulated into existence a science which has for its object not only the promotion and preservation of health, but also the prevention of disease. In the search for the causes and prevention of diseases the interests of the wage-earners have not been neglected ; indeed, it may be truly said that a special department has been created, known as Industrial Hygiene or Social Medicine, with a most complete and satisfactory literature of its own. German authors, in 1897, issued a volume of over 1,200 pages, and English authors, under the editorship of Dr. Thomas Oliver, devoted 891 pages to "Dangerous Trades" — "The Historical. Social and Legal Aspects of Industrial Occupations as 8 Affecting Health." The writer, during his visit to Berlin in September, 1907, met Dr. E. J. Neisser, who had just completed an "International Review of Industrial Hygiene," covering a volume of 352 printed pages. Dr. Neisser deplored his inability to present a general review of the work accomplished in the United States for the promotion of the welfare of the wage-earners, since, with the exception of the reports of the Inspector of New Jersey, no recent data concerning fac- tory sanitation were available for publication. Realizing the import- ance of the subject, not only to wage-earners, but to all interested in the conditions under which our fellow men and women live and work, an effort has been made in the succeeding pages to supply this information. It is, indeed, a feeble attempt towards amelioration of existing conditions, when compared with the monumental volumes of German and English authors. The writer acknowledges his indebtedness to Dr. Neisser for the inspiration given him by his own good and unselfish work, and also to all authors consulted by him, and to whom credit is given in the text. It is hoped that this study of the causes of sickness and the means of promoting industrial efficiency and earning power, will fill one of the obligations which your Committee assumed to discharge. Respectfully submitted, George M. Kober. INDUSTRIAL AND PERSONAL HYGIENE HY GEORGE M. KOI'.KR, M. I). Part I— INDUSTRIAL HYGIENE. INTRODUCTION. One of the most interesting and beneficent subdivisions of hygiene is a study of the relations of occupations to health and longevity. The necessity for devoting special attention to this subject was shown long ago by observations that certain occupations and trades are dangerous to health, and hence in the interest of wage-earners and the public at large it is clearly desirable to study these relations, to determine the sources and significance of the dangers, and the possible means for the prevention or the mitigation of the injurious effects. A pioneer study was made by Professor Ramazzini, of Padua, as early as 1700, and his monograph was translated into English in 1705, and also into French in 1777. In 1810 the French Government issued a decree relating to "etab- lissements dangereaux, insalubres et incommodes," and in 181 5 the English Parliament instituted a commission to inquire into the con- dition of factories, etc. In 1822 Mr. C. Turner Thackrah, of Leeds, wrote a monograph "On the Effects of the Arts, Trades, and Profes- sions, and of Civic States and Habits of Living on Health and Longev- ity." In 1833 and 1865 the English Parliament again appointed com- missioners, and in 1839 the "Academie des sciences morales et politiques de France," and subsequently Bavaria, Prussia, and the German Empire directed similar investigations. As a result of these efforts and numerous independent investigations, it is known today that per- sons habitually engaged in hard work, especially in factories and indoors, present a greater amount of sickness and higher mortality than persons more favorably situated, and that the character of the occupations influences to a great extent not only the average expecta- tion of life, but also the prevalence of certain diseases. It is known, for example, that bronchitis, pneumonia, and tubercu- losis are much more frequent in dust-inhaling occupations, and that the sharp angular particles of iron and stone dust are more liable to produce injury of the respiratory passages than coal, flour, grain, and IO other kinds of dust. It is also known that workers in lead, mercury, arsenic, phosphorus, poisonous dyes, etc., suffer especially from the injurious effects, and that other occupations, such as mining, railroad- ing, and those which necessitate working with or around moving machinery involve special danger to life and limb. For these reasons workers in many industries need special protec- tion, and in order to render this efficient it must be provided for by the enactment and enforcement of suitable laws. In 1833, 1864, 1867, and 1870, England enacted the so-called "factory laws." France provided a child labor law in 1841 and in 1874 a more satisfactory labor code. Germany and other continental governments enacted suitable legislation between 1859 and 1886. According to Miss S. S. Whittelsey's "Essay on Massachusetts Labor Legislation," child labor received attention in Massachusetts as early as 1836. The first law as regards safety and sanitation was enacted in that State in 1877, since which time all the States and Terri- tories have enacted some form of labor or factory laws. OCCUPATIONS AND MORTALITY. According to the United States Census for 1900, of 360,739 males, ten years of age and over, dying in the United States during the census year, 278,147, or J7%, were reported as having a gainful occu- pation. Of females, ten years of age and over, there were 324,075 deaths and 45,491, or 14%, were reported as having a gainful occupa- tion. In the aggregate the table on page cclx gives information as to the mortality by occupations for 5,575,745 males and 1,587,874 females. The death rates by occupation groups are as follows : Occupation — Males. All occupations Professional Clerical and official Mercantile and Trading Public entertainment Personal service, police and military Laboring and servant Manufacturing and mechanical industry Agriculture, transportation and other out door pursuits All other occupation Females. All occupations , Nurses and midwives • Servants Population 5.575,745 203,104 424,781 493,994 87,888 149,164 800,893 1,796,928 I,S28,24I 90,662 1,587.874 41,912 403,801 Deaths. 83,815 3,109 5-7i6 6,000 i,35o i,93i 16,158 24,769 24,196 586 J3.203 397 6,920 Death Rate. 1900. 1890 15.0 »5-3 13-5 12. 1 15-4 12.9 20.2 13.8 15-8 6-5 8.3 9-5 17. 1 13-8 15-7 9.8 12.3 M-S 15-4 22.6 13-0 10.5 11. 2 18.3 Each of the eight large groups of occupations is subdivided, and detailed information is given in sixty specified groups of employment II for males, and in fourteen groups for females, of which we have pro duced only two for females, on account of their high death rate. Unfortunately we have no reliable occupation mortality statistics and never will have, until greater attention is given this suhject hy health officials and the Census Bureau. In view of the importance of the suhject and the tendency elsewhere towards a more detailed classification and information for industl and trades, Mr. Frederick L. Hoffman ' says: "It was reasonably to be expected that the Census report of 1900 would materially increase the number of specific occupations dealt with in the section discussing the relation of occupation to mortality, but instead of 89 employments discussed in the Census of 1890, only 60 are dealt with in detail in the Census of 1900. To make this matter worse, the details are not given in the fundamental tables, but a vast majority of heterogeneous employ- ments are grouped in a purely arbitrary manner, filling space to no advantage, and resulting in conclusions of no practical value." He very properly objects to grouping together miners and quarry- men, because according to the Census of 1890 the comparative mortal- ity figure of quarrymen was 469, while that for miners was given as 1,127; "and to combine two such unlike occupations is the mere pro- duction of a figure which has absolutely no determining value, but the use of which must lead to false and mischievous conclusions." For like reason he objects to the grouping together of fishermen, oyster- men, sailors and pilots, which he very properly regards as three well- defined groups of employment. The mortality figure in the Census of 1890 for fishermen and oystermen was 543, for pilots it was 630 and for sailors 2,276. Many other combinations of employments, such as hotel keepers and boarding-house keepers, or saloon keepers with restaurant keepers are objectionable, as it does not enable the student of social questions to determine the effects of alcohol upon longevity. If, for example, restaurant keepers, who very generally do not engage in the liquor traffic, had not been combined with saloon keepers, bar- tenders, etc., the death rate of this group might not be so favorable but be more in accordance with the excessive mortality rates observed in this class in other countries. Mr. Hoffman points out that during the five years 1891-1895, during a condition of peace, the death rate of the U. S. Army was 6.6 per 1,000, and for the Navy 8.3 per 1.000. and concludes from this, that soldiers and sailors should not have been combined. We quite agree with him, as there is reason to believe that the factor of environment, such as close sleeping quarters and damp- 'Quarterly Publication of the American Statistical Association, December. 1002, p. 172. 12 ness, influence the life of sailors adversely. He also refers to a num- ber of misleading occupation death rates, because no correction is made for the difference in age distribution in widely different employments. As a result "the published rates do great injustice to employments, entirely healthy, while giving favorable position to employments the health conditions of which are quite the opposite. This point is readily illustrated, if comparison is made of the mortality of farmers and printers, the former of which according to the Census, experienced a mortality 'at all ages' of 17.6 per 1,000, against a death rate of 12. 1 per 1,000 for printers. Hence, apparently, printers enjoy a much lower mortality than farmers. Of course the opposite is the case. The inaccuracy of the rates is the result of radical differences in the age distribution of the two employments, there being 11.5% of farmers at ages 65 and over, while among printers there are only 1.5% living at this age period. * * * When proper comparison is made the mor- tality in farmers is considerably below that of printers at all periods of life." Mr. Hoffman's suggestions for improving vital statistics are worthy of careful consideration. The present Chief Statistician of the Division of Vital Statistics, Dr. Wilbur, is a trained physician, a keen student of social, sanitary and industrial questions, and perfectly familiar with the literature and the results achieved by more accurate and scientific methods of the treatment of the subject elsewhere. We may, there- fore, confidently expect more definite data concerning the relative danger incident to various occupations. MORBIDITY AND MORTALITY OF WAGE-EARNERS. The statistics of the morbidity and mortality of various occupa- tions, while far from satisfactory, and subject to more or less erro- neous conclusions, nevertheless indicate that persons habitually engaged in hard work are more frequently subject to disease and present a higher mortality than persons more favorably situated ; and this is especially true of factory employees, because their work is generally more monotonous, fatiguing, performed under less favorable surround- ings, and they are too often also badly nourished and badly housed. Rohe, in his "Text Book on Hygiene," presents a table of a large number of persons in the State of Massachusetts whose occupations were specified, the total number of decedents was 144,954; the average age at death was 50.90. From this tabulation it appears, that farmers and gardeners have the greatest expectation of life, with an average of 65.29 years : 13 Active mechanics, outdoors 5&I0. yars Active mechanics, indoors 47-.S7 years Inactive, mechanics, in shops 43 H7 yean Professional nun 5°^' years Merchants, financiers, agents, etc Laborers without special trades 47-4' years Factors, laboring abroad, etc 3&2Q years Employed on the ocean . 4644 years Females engaged in wage-earning occupations 30. 13 years Among the occupations usually classed as inimical to health are bleachers, bookbinders, brass founders, compositors, coppersmiths, electrotypers, stonecutters, gas-works employees, white-lead workers, match workers, persons employed in the manufacture of explosives, firemen, potters, file makers, and rubber-factory operatives. The following table from the reports of the Twelfth Census shows the death rates per 1,000 for leading causes and for all causes in certain occupations in 1900: DEATH RATE PER 1,000 EMPLOYEES IN CERTAIN OCCUPATIONS IN REGISTRA- TION STATES IN 1900, BY PRINCIPAL CAUSES OF DEATH. Occupation. Death rate per 1,000. Tuber- culosis Dis- eases of luufrs. system. 2. SO I.60 2.12 2.99 1-35 1.50 2.56 2.74 2.87 2.30 3-59 2.21 2.31 2-45 4.76 1.79 4-35 1.30 2.00 2.90 2.29 2.08 2.36 .91 3-u 1. 01 2.27 2.67 i-95 1.24 5-40 1. 10 2-93 2.26 2.07 .84 1.98 4-47 3-J9 2.13 2.94 .90 2.18 1-43 3.6s 1-77 2.61 .89 1. 11 3.70 1.20 1.29 •95 Dis- ] icri- e*s€sofl dent- urin»ry and in- ".ani juries. MANUFACTURING AND MECHANICAL INDUSTRIES. Bakers and confectioners Blacksmiths Boot and shoe makers , Brewers, distillers, and rectifiers , Butchers , Cabinetmakers and upholsterers , Carpenters and joiners , Cigar makers and tobacco workers , Compositors, printers, and pressmen.... Coopers Engineers and firemen (not locomotive) , Iron and steel workers Leather makers Leather workers Machinists Marble and stone cutters Masons (brick and stone) Mill and factory operatives (textiles)..., Millers (flour and grist) Painters, glaziers, and varnishers Plumbers and gas and steam fitters Tailors Tinners and tinware makers AGRICULTURE, TRANSPORTATION OUTDOOR. AND OTHER Draymen, hackmen, teamsters, etc... Farmers, planters, and farm laborers. Miners and quarrymen Steam railroad employees 1.02 1.90 i-45 2.22 i-77 1.61 2.23 i-7S •93 2.72 1.80 1. 01 1.26 2. 11 i-°3 i-59 2.32 .90 3.81 1.69 •59 1.28 1.36 • 9S 2.62 .88 1. 17 1.68 ■95 2.40 1.72 i-73 1.46 2.15 1. 15 2.09 >-77 1.81 1-3' •97 1. 10 J-37 2.30 .80 2.97 J-54 1. 13 1. 13 i-37 1.47 1.49 •77 .60 1-45 1.90 .78 2.56 1-36 '■57 1-73 1.68 •93 3-o8 1.66 ■ 77 ■84 3.27 .98 •83 1.83 •57 1. 16 1.82 .88 1.38 1.31 0.61 1. 00 •33 '■3 7 .81 .64 1. 18 .70 •49 1.36 1.83 .78 .66 •97 •7' •99 i-57 •75 1.98 1.28 ■ ;6 •51 •91 3.78 4.10 »23 18.3 9-4 '9-7 16.1 18.0 17.3 18.7 13. 1 33.8 '5-7 10.7 I3.J »7-5 10.5 J 4-9 11 26.6 16.3 9' 11.8 '4-5 11. o I7« 10.8 The following table from the report of the registrar-general of Fngland and Wales shows the comparative mortality of occupations 14 in England and Wales 1890- 1892. The average mortality of all males of the population between 25 and 65 years of age was placed at 1,000. The mortality of occupied males was 953 and of the unoccu- pied 2,215. The comparative mortality of the different groups was as follows : Occupation. Compara- tive mor- tality. Occupation. Compara- tive mor- tality. 533 553 563 604 664 783 821 845 8S9 966 989 1,001 1,096 1,096 Cotton manufacturer, Lancashire 1,176 1,284 i,3 22 1,427 Innkeeper, hotel servant Potter, earthenware manufacturer Medical practitioner 1,706 1,810 A reasonable explanation for the excessive mortality in some of the occupations will be found in subsequent pages ; the high rates in brewers, innkeepers, and hotel servants are believed to be due to the effects of alcohol. According to Rauchberg 1 the average number per 1,000 members of the "Vienna Sick Benefit Society" taken sick during a period of 17 years was 423 per annum distributed as follows: Occupation. Average number taken sick per 1,000 members. Occupation. Average number taken sick per 1,000 members. Assistant machinists Factory employees & day laborers Foundrymen Blacksmiths Masons and stonecutters Painters Weavers and spinners Locksmiths 477 473 451 437 378 367 354 Iron workers Shoemakers Tinners and bronzers Cabinetmakers and wood workers Saddlers Tailors and furriers Other mechanics 35i 343 339 326 282 215 463 Industrial diseases and industrial accidents are everywhere assum- ing more and more importance and our knowledge should be based upon accurate data. In countries like England, where reports of cer- tain occupations are compulsory, it is quite possible to secure, for example, reliable data as to the number of cases of lead poisoning. The same may be said of the facilities afforded by the statistics of the "German Industrial Insurance Institutes," which furnish not only the number of deaths, but also the number of cases treated, together 'Die allg. Arbeiter-Kranken und Invalidencasse in Wien, il »5 with the age period and the duration of the disease. Similar facts should be collected in this country. This is all the more important when it is remembered that even with the most complete Btati it is extremely difficult to determine all the factors which influence the health and longevity of operatives. Greal differences are found in the conditions under which the work is performed, some of which are entirely avoidable, while others are not, and it is hardly fair to characterize certain trades as dangerous, when experience has shown that no harm results when proper safeguards have been taken. In the consideration of this question the personal element of the work- men, their habits, mode of life, food, home environments, etc., can not be ignored. There are a number of occupations in which the alcohol habit prevails to an unusual extent, perhaps because of the character of the work, perhaps as a result of association, and it would not be fair to attribute the ill health of the operatives altogether to the character of the employment. Again, many persons are engaged in occupations for which they are not physically fitted, while others ruin their health by vice, dissipation, improper food, and insanitary environments at home. In addition to all this there are factors, such as water and soil pollution, for which neither the industry nor the individuals are primarily to blame. Thus, for example, the general anaemia of the agricultural classes in Porto Rico was attributed a few years ago to their occupation and starvation, when as a matter of fact it was caused by the "hook-worm disease." Recent investiga- tions conducted by Doctor Stiles appear to indicate that the same disease prevails to some extent among the textile operatives in the South. All this indicates the need of a thorough study of the condi- tions affecting health in various occupations, not only to determine the relative health risks and the causes of the undue prevalence of certain diseases in certain occupations, but also to formulate rules which may remove the causes or render the system better fitted to resist them. In this, as in all preventive efforts, a hearty co-operation of the parties interested is absolutely essential for the attainment of the highest measure of success. In this instance the responsibility rests with the State, the employer, and employees ; each have certain duties to perform, and the help of all is essential for the mitigation of existing evils. INDOOR OCCUPATIONS. Indoor employment, broadly speaking, is inimical to health, while outdoor work in a pure air favors health and longevity. Without underrating the influence of insanitary dwellings, improper and i6 insufficient food, lack of recreation, and other factors, there is no doubt that one of the chief dangers of indoor life is exposure to vitiated air. The air of dwellings and workshops is never as pure as the outer air, because it is polluted by the products of respiration, combustion, and decomposition, and the presence of individuals also tends to vitiate the air with dust, germs, and organic matter from the skin, mouth, lungs, and soiled clothing. Unless proper provision is made for the dispersion of foul air and the introduction of pure air there is much reason for assuming that these impurities play a more or less impor- tant role in what has been designated as "crowd poisoning," character- ized in the acute form by symptoms of oppression, headache, dizziness, and faintness, while the chronic effects of deficient oxygenation and purification of the blood are plainly evinced by the pallor, loss of appetite, anaemia, and gradual loss of physical and mental vigor. All of these effects are intensified when human or animal beings are obliged to occupy rooms with an air supply insufficient for the proper oxygenation of the blood, and as a result of this habitual exposure to vitiated air, we note an undue prevalence of consumption in crowded workshops, dwellings, prisons, public institutions, and formerly also in military barracks and battle ships. Even live stock shows the baneful effects of insufficient air space for tuberculosis among the range cattle of the far west, which are practically without shelter, is comparatively rare, while it affects from 15 to 25 per cent, of dairy herds, which are housed, but without sufficient regard to light and air. Improved ven- dition and increased air space has everywhere lessened the death rate, and it is chiefly by just such measures that the rate from con- sumption has been reduced from 11.9 to 1.2 per 1,000 in the British armies. As a matter of fact, an abundance of pure air has been found the most important factor in the treatment of tuberculosis, because it promotes oxygenation of the blood, stimulates the appetite and nutri- tion, and thereby increases the general resisting power of the system. OCCUPATIONS INVOLVING EXPOSURE TO IRRITATING DUST. It has long been known that dust-inhaling occupations predispose to diseases of the respiratory passages, which may result in consump- tion. The particles of mineral dust produce an irritation of the mucous membrane of the nose, throat, respiratory organs, and eyes, and the hard, sharp, and angular particles of iron and stone dust may cause actual abrasions. According to Arnold 1 the dust which is 'Untersuchungen ueber Staubinhalation, etc., Leipzig, 1885. •7 inhaled lodges on the RIUCOUS membrane of the air p;i - ag< and cles of the lungs, there to be coughed up, although some of the finest particles are taken up by the epithelial < '11 and white corpu carried to the nearest lymphatic glands. The coarser particles, such as iron, stone, or coal dust, usually lodge upon the Burface to be coughed up with the secretions. If not expectorated they will cause harm by clogging up the air vesicles and interfere with respiration. In the meantime not infrequently an irritation is set up, causing catarrhal conditions of the mucous membrane, or a more serious chronic inflam- mation of the respiratory organs, so common among persons engaged in dusty occupations. The chronic inflammatory conditions thus produced favor infection with the tubercle bacillus. At all events Hirt's statistics show that men employed in dust-producing occupa- tions suffer much more frequently from pneumonia and consumption than those not exposed to dust and that there is practically no differ- ence in frequency of disease of the digestive system. The relative frequently of these diseases per 1,000 workmen is as follows: 1 CASES OF CONSUMPTION, PNEUMONIA, AND DIGESTIVE DISORDERS PER 1,000 WORKERS IN CERTAIN OCCUPATIONS. Workers in metallic dust. . . . Workers in mineral dust.. Workers in mixed dust.... Workers in animal dust.... Workers in vegetable dust. . . Workers in nondusty trades Con- sump- tion. Pneu- monia. Diges- tive dis- orders. 28.0 25.2 17.4 5-9 17.8 16.6 22.6 6.0 '5-2 20.8 7-7 20.3 13-3 1 1.1 9-4 4.6 15-7 16.0 Perlen in his "Inaugural Dissertation," Munich, 1887, 2 discussed the records of the Munich Polyclinic, where 65,766 persons were treated between 1865-1885, including 4,177 tuberculosis patients, viz., 2,801 males, 1,263 females, and 83 children. Of these, 1,425 patients had been engaged in occupations wdiere they were exposed to dust, viz : 30 per cent were by reason of occupation exposed to metallic dust. 26 per cent were by reason of occupation exposed to vegetable dust. 18 per cent were by reason of occupation exposed to mineral dust 17 per cent were by reason of occupation exposed to mixed dust. 8 per cent were by reason of occupation exposed to animal dust. According to the reports of the Census of 1900 the consumption death rate of marble and stonecutters in the United States is six times that of bankers, brokers, and officials of companies, and the mortality in fifty-one other employments ranges between these extremes. 1 Cited by Harrington, Practical Hygiene. 1002, p. 67S. 2 Cited by Uffelmann, Handbuchd. Hygiene, 1800, p. 587. i8 The amount of dust is perhaps less important than the character of the particles which compose it. The susceptibility to consumption in metal workers, and stonecutters can only be explained by the fact that the hard, sharp, and irregular particles of this kind of dust are more apt to produce injury of the mucous membranes of the respira- tory tract. But it is not fair to assume that the less irritating dust is free from danger, for as pointed out by E. Roth 1 even the inhalation of plaster of Paris or flour dust can not be regarded with indifference, especially when it is preventable. Ahrens 2 found the amount of dust for each cubic meter of air in certain industrial establishments as follows : Mg. Horsehair works 10 Sawmill 17 Woolen factory 20 Woolen factory with exhauster 7 Paper factory 24 Laboratory 1.4 Mg. Flour mill 28 Foundry 28 Polishing room of foundry 71.7 Felt shoe factory 175 Cement works 224 According to Schuler and Burkhardt, cited by Roth, the morbidity among 1,000 workmen engaged in dusty occupations is as follows : Paper factory employees 343 Mechanical industrial shops 419 Wood turners 427 Laborers in the rag storeroom of a paper factory 429 Bookbinders 98 Silk weavers 205 Cotton spinners 235 Printers 250 Cotton weavers 285 Type founders and typesetters 304 According to Sommerfeld, cited by Roth, the mortality in Berlin of persons engaged in nondusty occupations is 2.39 per 1,000; of per- sons engaged in dusty occupations is 5.42 per 1,000; the mortality of the Berlin population at the same ages is 4.93 per 1,000. Of 1,000 deaths the number of deaths from consumption in occu- pations without development of dust was 381 ; in occupations with development of dust it was 480 ; in the Berlin population at the same ages 332.3. METALLIC AND MINERAL DUST. It will be readily understood that in the cutlery and tool industry, especially in the grinding and polishing departments, more or less dust is evolved not only from the metallic surfaces, but also from the numerous grindstones, and emery and corundum wheels. This dust production is not wholly avoidable, even when the wet process is employed. It is known that occupations involving the inhalation of this dust tend to produce diseases of the lungs, such as bronchitis, peribronchitis and fibroid pneumonia, but tuberculosis, also spoken Compendium der Gewerbekrankheiten, Berlin, 1904, p. 106. 2 Archiv fur Hygiene, 1894, Heft 2. 19 of by the workmen as "grinders asthma" and "grinders rot" leads the list. Moritz and Roepke 1 have shown that 72.5 per cent, of the deaths among the metal grinders of Solingen are due to consumption, as com- pared with 35.5 per cent among the general population. The death returns for 12 years of the city of Northampton, M one of the centers of the cutlery and tool industry, show that among 'grinders," "polishers," and "cutlers" diseases of the lungs were responsible for 72.73 per cent of the mortality inclusive of 54.5 per cent of deaths from tuberculosis.* Hirt gives the percentage of consumption in the total number of sick among different classes of workers in metal as follows : Needle polishers, 69.6 per cent; file cutters, who are also exposed to inhala- tion of lead, 62.2 per cent; grinders, 40 per cent; nail cutters, 12 per cent. Greenhow 3 over 50 years ago called attention to the excessive mortality among the needle polishers of Sheffield. Beyer 4 found that of 196 needle polishers at Remscheid only 24 were over 40 years of age. The reason why this occupation is especially dangerous, is because the "wet process" can not be employed for small objects, which moreover have to be brought more closely to the eyes, and thus the chances for the inhalation of this metallic dust are increased. The danger in all such establishments can be reduced to a minimum by the employment of respirators and forced ventilation to carry the dust away from the operator. The Massachusetts report, cited above, states that "even when employers have provided hoods, connected with a system of exhaust fans or blowers, a very large proportion of grinders recklessly remove the hoods, and thus expose themselves unnecessarily to this especially dangerous form of dust. They assert that they prefer freedom of movement, with dust, to the protection offered by hoods." Stonecutting is regarded as a dangerous occupation, and con- sumption is quite common among men engaged in the industry. Those who have witnessed the various operations realize that in spite of wet processes, and employment in the open air, the workmen are exposed to a great amount of this irritating form of dust, especially those who operate the pneumatic tools. 1 Cited by Roth. p. 26. ^Report of the State Board of Health of Massachusetts upon the sanitary condition of factories, workshops, etc.. 1907. p. 87. 3Cited by Sander. Handbuch der oeffnetl. Gesundheitspflege, 1885. p. 106. 4Beyer. Die Fabrikindustrie des Reg. B. Duesseldorf. 1876. 20 A collective investigation published in iqoi, and cited by Roth 1 shows that of every ioo deaths among stonecutters, polishers, and quarrymen 86 were due to diseases of the lungs, inclusive of 55 deaths from consumption. Of 2,013 stonecutters examined by Sommerfeld, 19.7 per cent were afflicted with consumption ; 17.98 per cent with other diseases of the lungs, and nearly all had a chronic catarrh of the throat or larynx. According to the report of the Board of Health of Massachusetts, previously cited, 2 of 343 deaths which occurred in the city of Quincy, Mass., among stonecutters during a period of about 16 years, 41.4 per cent were due to pulmonary consumption; 12 per cent to other dis- eases of the lungs; 12.8 per cent to diseases of the heart; 7 per cent to violence and 26.8 per cent to all other causes. Mr. Frederick S. Crums calls attention to the excessive average mortality rate from consumption, 205.4 in Barre, Vt., which he attrib- utes to the stone cutting industry. Millstone and slate cutting are also regarded as dangerous occupa- tions. Persons engaged in glass cutting and polishing are not only exposed to the inhalation of a sharp and irritating dust, but also to lead poisoning from the use of putty powder, which contains 70 per cent of lead oxide. In glass establishments in Massachusetts, where all the cutting and polishing is done by the wet method, no dust is perceptible and the employees as a class appear to enjoy good health. Gem finishers also have a high consumption and sick rate. Work- ers in mica dust and bronzing powders used in the manufacture of wall papers, fancy souvenir cards, moldings, frames, etc., are predis- posed to diseases of the respiratory passages, and the bronze powder in addition is liable to produce headache, loss of appetite, nausea, vomiting, and diarrhea. It is said of the bronzing department of some of the lithographing establishments in Massachusetts, that in spite of the exhaust ventila- tion the air is heavy with bronze dust most of the time. 4 "The boys who run the fine bronzing machines wear handkerchiefs over the nose and mouth. They look pale and unhealthy, and all show the charac- teristic green perspiration due to contact with bronze. The great majority of the employees appear to be healthy." In the manufacture of machinery and metal supplies some of the Compendium der Gewerbekrankheiten, Berlin, 1904, p. 108. 2 Page 79. 3Quarterly Publication of American Statistical Association, December, 1907, P- 465- 4Report of the State Board of Health of Massachusetts upon the sanitary condition of factories, workshops, etc., 1907, p. 80. 21 operations involve exposure to 'lust, funics, vapors, or extreme beat In some of the processes, where emery wheels and revolving wire brushes are used, enormous amounts of fine jteel and emery dust are given off, unless equipped with exhaust ventilating appliances. In a Massachusetts investigation covering 24 establishments the air of some of the rooms was found exceedingly dusty and about one-tenth of the occupants looked pale and sickly, and complained of the irrita- tion of the air passages by the dust. The number of employ* these establishments ranges between 12,500 and 15,000. Some of the establishments were models in character as regards light, ventilation, and general sanitation. "The tumblers and emery wheels are pro- vided with hoods and blowers which are effective and there is practi- cally no dust. The rooms in which castings are dipped are properly ventilated and all fumes are effectively removed. All of the machin- ery is well protected." One brass foundry was reported where the air was heavy with fumes, especially in winter, no mechanical ventilation being installed, and in which the workmen have occasional attacks of "brass founders' ague." The following may be taken as a fair statement of the hygienic aspects of the machinery and metal industry : "While the nature of some of the processes is such as to warrant classification of this industry with the dangerous trades, the conditions under which the work is done are very largely responsible for the injurious effects on the health of the employees, and these conditions are to a considerable extent avoidable or at least susceptible of improvement." The same Massachusetts investigation covered 14 iron and steel foundries and 9 stove foundries. In one -establishment, the department in which the castings are sand blasted was found very objectionable, as the air was heavily impregnated with flying sand, which "gets into the mouth, nose, and eyes and the employees suffer considerably from soreness of the last-mentioned organs." In another establishment this condition is very much ameliorated by a large flaring hood in the center of the room with upward-suction draft, the operatives wearing helmets with fine wire inserts to protect the eyes, and cloths under- neath the helmets to protect the nose and mouth. In one of the stove foundries, "the dust from the polishing and buffing process, in the absence of hoods and exhaust ventilation, is so thick that objects a few feet distant can not clearly be made out. Many men refuse to work in this establishment in the hot months on account of the excessive heat and general discomfort. In some instances, however, where the neces- sary protection is afforded by the employer, the men habitually remove the hoods and become covered with emery and iron particles." 22 In the crushing, grinding, and sifting process incident to the manu- facture of emery, corundum, and sandpaper more or less fine dust is given off in spite of the fact that the machines are more or less com- pletely inclosed. The emery and corundum industry must be classed among the trades intrinsically dangerous to health, on account of the peculiarly irritating character of dust. But as is the case with other dusty occupations, few of those employed can be induced to wear respirators. Coal miners, charcoal men, firemen, chimney sweeps, etc., are exposed to constant inhalation of coal dust and soot, and though sub- ject to chronic bronchial catarrh, consumption is not especially common among them. VEGETABLE DUST. Millers and bakers inhale flour dust, and according to Hirt 20.3 per cent of all the diseases in millers are pneumonia, 9.3 per cent bronchial catarrh, 10.9 per cent consumption, and 1.9 per cent emphysema (abnormal collection of air in the lungs). The tuberculosis death rate according to Schuler among millers in Switzerland is 3.75, as com- pared with 2.95 per 1,000 in the general population. Carpenters, joiners, cabinetmakers, etc., are exposed to wood dust, and the dust from hard wood is probably more injurious than that from softer kinds. Dr. E. J. Neisser 1 refers to a wooden-tool factory at Stras- burg which in 1904 furnished 15 cases of sickness out of the 20 em- ployees, with 288 days loss of work, distributed as follows — diseases of the eyes, 1 ; of nose, 1 ; throat, 2, and diseases of the lungs, 6. The Massachusetts Board of Health found that in the agricultural tool and implement industry a hard wood called "coca-bola," which is used for tool handles, evolves a very pungent and irritating dust, pro- ductive of inflammation of the eyes and skin. Some persons in the course of a week or two, become accustomed to its effects, while others are obliged to discontinue work in the department. 2 The medical inspector of Great Britain, according to Neisser, reported a number of toxic symptoms which occurred among persons engaged in the manufacture of weaver shuttles made from African boxwood. Investigation revealed the presence of an alkaloid in the wood, which acted as a heart depressant, producing a slow and inter- mittent pulse; headache, drowsiness, watering of the eyes and nose, difficulty in breathing, nausea, and weakness. Internationale Uebersicht ueber Gewerbehygiene, Berlin, 1907. 2 Report of the State Board of Health of Massachusetts upon the sanitary condition of factories, workshops, etc., 1907, p. 89. 23 Laborers in grain elevators and grain threshers inhale a very irri- tating dust, which may cause acute and chronic catarrh of the QlUCOttS membranes. Workers in tobacco suffer more or lesi from nasal, con- junctival, and bronchial catarrh and digestive and nervous derange- ments, and although the mucous membranes gradually become accus- tomed to the irritation of the dust and fumes the occupation appeafl to be dangerous, as the consumption rate ranks next to that of stonecutters. It is said that female workers in tobacco are more liable to mis- carry; at all events Doctor Rosenfeld, cited by Roth (p. i66j, found this to be true in Austria. Dr. E. R. Tracy, of New York, reports that 325 cigar makers' families visited by him had only 465 children, an average of 1.43 to each family, and feels disposed to attribute this to the frequent abortions among the female operatives. This experi- ence is not confirmed by recent observations made in German tobacco towns like Giessen, for example (Neisser, p. 125), and more extended investigations are called for. Some authors maintain that tobacco dust exerts a protective influence against infective agents and instance the fact that during the cholera epidemic of Hamburg in 1892 there were only 8 cases among the 5,000 resident cigar makers. The Massa- chusetts report previously cited in discussing the cigar and cigarette factories in Massachusetts refers (p. 49) to the spitting habit and the objectionable practice of finishing cigars with the aid of saliva. This practice was observed in more than one-third of the places visited, and in 18 factories the practice of biting off the end of the filler and inner wrappers with the teeth was also observed. The report reiterates the statement made to the legislature in January, 1905, as to the possibility of disseminating loathsome diseases, through this practice. Such con- ditions certainly emphasize the necessity for the use of cigar holders. TEXTILE INDUSTRIES. Operatives in cotton and flax textiles are perhaps more subject to dust inhalation and various diseases of the respiratory and digestive organs than those of woolen mills. The Census Report of the United States for 1900 gives the death rate among 150,783 male mill and factory operatives (textiles) as 8.1 per 1,000, and of the 162,932 female operatives as 4 per 1.000. As pointed out by Mr. F. L. Hoff- man it would have been exceedingly interesting to learn the death rate among cotton, linen, wool and silk workers. The phthisis death rate in 1892 in Belfast « with its 30,000 persons engaged in the linen industry l G. H. Ferris, Journal of State Medicine, March. 1895. 24 was 4.1 per 1,000 against 1.4 for the whole of England and Wales and 2.1 for Ireland. According to Schuler and Burkhardt 1,000 linen spin- ners furnish annually 221.6 cases of sickness; 1,000 weavers 202.7, while female operatives suffer even more, the sick rate being 249.5 and 334.4 for the respective occupations. CASES OF SICKNESS PER 1,000 EMPLOYEES AMONG SPINNERS AND WEAVERS. Disease. Cases per 1,000 spin- ners. Cases per 1,000 weavers. Diseases of the digestive organs Diseases of the respiratory organs... Diseases of the motor organs Diseases of a constitutional character 58.7 47-7 29.6 22.9 103.4 Sa-S 21 .2 31-6 Arlidge 1 gives a table showing the comparative frequency of the most important diseases in the case of 739 weavers, and of 676 persons following the several other branches of the cotton industry, such as winders, spinners, reelers, curlers, mill hands, grinders, etc., and who for convenience sake are designated by him as machine-room workers. The figures are based on 1,415 operatives who received treatment as in and out patients in connection with the Preston Hospital during a period of six years. Disease. Per cent of weavers treated for specified disease. Per cent of machine- room work- ers treated for speci- fied disease. Phthisis Dyspepsia Bronchitis Varicose veins and ulcers Rheumatic affections Uterine disorders and displacements Neuralgia Throat affections Renal diseases Epilepsy Heart diseases Debility Anaemia 1 1 .90 21 .00 31-30 6.80 11.68 8-43 4-43 2.51 2.66 3-40 5-32 9.17 2.50 It will be observed that the Swiss and English statistics both reveal an undue prevalence of the diseases of the :respiratory and digestive organs. It has been suggested that the constrained position of weavers is to a large extent responsible for the undue prevalence of dyspepsia among the Swiss weavers, but other factors like improper food, indoor life, and home conditions should be considered. This is apparent from the fact that the percentage of cases of dyspepsia among the English 'Arlidge, "The Hygiene, diseases, and mortality of occupations," London, 1892, p. 361. 25 weavers is smaller than among the machine-room worker . The con- stitutional disorders like anaemia, chlorosis, neuralgia, and debility are likewise due to a variety of cause , chief of which arc vitiated air, resulting from defective ventilation of the workshop . overwork, in- sufficient or improper food, and insanitary homes. Uterine derangements and displacements may very properly be attributed to general debility, overwork, and long standing in hot and moist workrooms, and, like varicose veins and ulcers and "flat may be expected to develop in other occupations involving long stand- ing. (See occupations involving constrained attitudes. I The undue prevalence of pulmonary diseases among the textile operators can be accounted for by a number of factors, such as the presence of very fine cotton or flax dust or "fly ;" air vitiated by the products of respiration and combustion, the presence of infectious germs from the promiscuous expectoration habit ; faulty life and home surroundings. Of these the presence of "fly" is doubtless a very important predisposing factor, since it is generally admitted that this dust acts as an irritant to the respiratory passages, and sooner or later prepares the way for the invasion of the germs of tuberculosis, pneu- monia, etc. Coetsem describes the so-called byssinosis or "pneumonie cotonneuse," but it is by no means settled whether in these cases we have to deal with a typical occupation disease, or with a specific infec- tion, in which the inhalation of the cotton dust simply operates as a predisposing cause. It is very probable, however, that the habitual inhalation of this dust may produce disease of the lungs not necessarily tubercular. Arlidge says : "If inhaled longer, it reaches the bronchi, and sets up cough with white mucous expectoration. The cough will be for years chiefly a morning phenomenon on first rising, but it is also induced upon leaving the warm workroom. Fine fibers of cotton are found, on microscopical examination, in the sputum, and as these make their way into the pulmonary tissue they set up morbid action, resulting in increasing density of it on the one hand and of emphysematous expansion on the other. These morbid changes are accompanied by dyspnoea, wasting, and debility, but rarely with hemoptysis [spitting of blood], and together constitute a group of symptoms not inappro- priately termed 'industrial phthisis.' Moreover, intercurrent diseases cf the lungs, such as acute bronchitis and pneumonia, often arise and terminate life, and true tubercular phthisis is no uncommon cause of death." The chief requirements for the amelioration of existing conditions in the .textile industry are efficient machines for the prevention and 26 removal of dust. The utmost care should be taken to provide the most perfect methods so far devised for the removal of dust and for proper ventilation. The lighting should be good, both for day and right work, giving preference to electricity. The temperature and humidity of the rooms should be regulated, and children under the age of 14, or those with weak chests, should not be employed at all in the cotton mills. In the textile industry in Massachusetts analysis of the death returns during the year 1905 from the three principal "mill towns" shows that although tuberculosis is one of the leading causes of death among mill operatives the general death rate of this class was by no means abnormally high, being, respectively, 7, 8, and 10 per 1,000. Tuberculosis caused, respectively, 32, 23.57, an d 21 per cent of the deaths. It appears also that the general death rates of the cities whose population includes the highest per centage of the textile operatives compare not unfavorably with those of certain other cities which are engaged in other kinds of manufacture or are more residential in char- acter, in spite of the high rate of infant mortality which appears to be inseparably connected with mill populations everywhere. 1 A source of danger is the presence of infectious dust from dried sputum in the air of different mill rooms on account of the indiscrimi- nate habit of spitting. The report also includes an excellent summary of the results obtained by an inspection of 93 manufacturing establishments and the conditions found in a certain proportion of weave and spinning rooms are tabulated as follows: I, Poor light; 2, Presence of carbon-dioxide and carbon-monoxide in the air; 3, Non-regulation of artificial moist- ure, (a) excess of moisture, undue heat, or (b) no artificial moisture, excessive heat; 4, More or less dust ("fly" dust from sizing, etc.) ; 5, Lack of cleanliness ; 6, Lack of provision for a plentiful supply of fresh air. In the majority of mills the toilet and wash rooms were found to be beyond criticism ; but in not a few "the imperative need of improvement as regards structure, location, ventilation and common decency" are pointed out. The number of accidents in textile mills, considering the large number of fast-running machines, is not large, during a period of almost five years at the Pacific Mills, with about 5,200 employees, amounting to 1,000, classified as follows: Report of the State Board of Health of Massachusetts, 1907, p. 16. 2/ Accidents to employees of the Pacific Mills, Lawrence, Mass., August io, 1900, to July 13, 1905. Killed outright I Fatally injured I Seriously injured (broken limbs or amputation necessary) 86 Slightly injured 910 Unclassified (suffered nervous shock, but physically uninjured) 2 1,000 The underlying cause of injury is given as follows: Careless manipulation 539 Deliberate carelessness (taking chances of being injured, such as cleaning machinery while running, etc.) 164 Inattention to surroundings 177 Carelessness of fellow-workman 51 Unforeseen liability 60 Unclassified 9 In three mills in Massachusetts devoted to the manufacture of twine, cordage, and gunny cloth from jute and hemp some of the work- rooms are reported to be exceedingly dusty in spite of mechanical ven- tilation and open windows. "Many of the operatives wear thick bunches of fiber over mouth and nose as a protection. A fairly large proportion of the operatives show the effects of their employment, looking pale and sickly." In the room where the sisal hemp is fed into breakers the air is filled with dust. "In one of the establishments the employees in all departments look well and strong, although the air in some parts contained considerable dust." 1 In five Massachusetts carpet and rug factories, employing about 6,000 persons, about 10 per cent of whom are between the ages of 14 and 16, the largest of these factories shows some departments in which poor light, excessive heat, moisture, and dust constitute objec- tionable conditions. In one room there was "so much fine cotton dust and fiber in the air that it is with difficulty one can see across. This dust is very irritating to the nose and throat." In one of the establish- ments the children are described as very small and poorly developed for their age "to be allowed to work 10 hours and 20 minutes for 5 days in the week." In another factory "about one-tenth of the employees look sickly." The smallest factory employs 500 persons, "has good 'Report of the State Board of Health of Massachusetts upon the sanitary condition of factories, workshops, etc.. 1907, p. 46. 28 light, adequate ventilation, and commendable weave rooms, and the employees appear to be in good health." One of the shoddy mills examined was poorly lighted, inadequately ventilated, dusty, and ill kept ; the other was light, clean, and well venti- lated. "Some of the women employed appeared to be in poor physical condition. In the six felt-cloth factories examined the work was found to be conducted in fairly lighted and, apart from dust, adequately venti- lated buildings. In each there was more or less dust, especially in the picking and carding rooms ; but the amount was much diminished in most of them by means of blower fans." ANIMAL DUST. Of the several classes of dust, that from wool is considered to be less irritating than flax or cotton, and horn is believed to be more irri- tating than bone. The conditions found in some of the woolen mills in Massachusetts as regards light, ventilation, and general cleanliness are reported as far from satisfactory; but in the absence of morbidity statistics it is difficult to determine the degree of danger to which the operatives are exposed. In the boot and shoe industry in Massachu- setts, where there is more or less animal dust evolved, some effort is being made to remove the dust by exhaust flues attached to the ma- chinery. Of the 373 factories summarized by the Massachusetts Board of Health Report previously cited, "126 are partially, and a fair propor- tion of these are wholly, equipped with this means of protection ; in 88 of these 126 one or more machines are not so equipped; and in 49 of the 88 there are rooms in which the air, apart from the escaping dust, is noticeably bad. The number of machines with means for effi- cient or fairly efficient removal of dust was found to be 1,630; the number either inefficiently equipped or devoid of equipment was re- ported as 2,769. * * * While in general the health of the em- ployees appears to be fair to good, in 85 factories a considerable pro- portion of them are noticeably pale and unhealthy in appearance." The pale and poorly nourished condition of youthful employees is also emphasized. The dust and moisture involved in the polishing departments of the horn and celluloid industry, and the irritating fumes given off by a "dip" containing glacial acetic acid, are sources of possible injurious effects to the employees . In the manufacture of derby and felt hats, apart from the exposure to dust from the fur which comes to the factory clipped from the skin, there is also a certain degree of danger from cyanide of mercury 29 with which the fur is treated, in four felt-hat factories inspected bj the Massachusetts Board of Health, "the employees appeared to be healthy." In some of the establishments visited the fumes of wood alcohol in the drying department were markedly strong. "The work- men stated that they arc frequently troubled with headaches, vertigo, smarting and burning of the eyes, and impairment of vision, and that few can remain at this work longer than three or four months at a time." This could readily be prevented by the use of "denatured" alco- hol. In the "pouncing process," which consists in smoothing off the rough hairs from the hat rim and other parts, "a great deal of very f?ne dust is given off." Mr. Frederick S. Crum 1 gives the mortality rate from consumption in Orange, N. J., as 289.9 as compared with the average of 151.0 for the 200 small cities investigated by him, and attributes this excess to the fact that in 1905 there were 1,379 employees engaged in the felt-hat industry in Orange. In the brush-making industry hogs' bristles and vegetable fibers are used. In seven brush factories in Massachusetts "the general condi- tions were found to be beyond criticism and the health of the employees appeared to be fair or good." Hirt regarded brush making as a dangerous occupation, as nearly one-half of the deaths among the brush makers were from consump- tion, due probably to the inhalation of the sharp fragments of bristles. There are no adequate reliable data as to effects of animal dust given off in the manufacture of woolen goods, silk, feather, fur, hair, horn, bone, shell, ivory, etc. It is reasonable to assume, however, that the dust from all these sources is capable of setting up an irritation and inflammation of the respiratory passages, though not as intensive as that caused by mineral constituents of dust. In the hair, brush, and wool industry there is also some danger from disease germs. OCCUPATIONS INVOLVING EXPOSURE TO INFECTIVE MATTER IN DUST. RAG. PAPER, WOOL AND HAIR INDUSTRY. It has been held for a long time that germs of infectious diseases like smallpox, anthrax, scarlet fever, tuberculosis, typhus and typhoid fever, diphtheria, measles, and cholera may cling to body and bed clothes and prove a source of danger to those coming in contact with Quarterly Publication of the American Statistical Association, December, 1907, p. 464. 30 rags in the rag business and paper industry. 1 The danger while per- haps overrated, is nevertheless real and can be guarded against only by a thorough disinfection of the rags by steam under pressure before they are handled at the paper mills. The occupation is evidently inimical to health. Of 4,857 German operatives reported by Uff elmann, 50 per cent are annually taken sick ; about 34 per cent of those engaged in the handling of dry rags suffered from affections of the respiratory passages, and only 21.9 per cent of those otherwise engaged in the same establishments, all of which speaks strongly for the necessity of proper ventilation and exhaust flues for the removal of dust. In this connection it is proper to refer to the dangers of the so- called "rag sorters' " and "wool sorters' " disease, which are nothing more or less than anthrax infection — a disease transmissible from animals to man by means of wool, hides, hair, and horsehair. Two hundred and sixty-one cases with 67 deaths, were reported, according to Neisser, in England from 1899-1904. Of these, 88 occurred among those engaged in the wool industry, 70 cases among persons engaged in curled-hair and brush factories, 86 in persons engaged in tanneries and hide trades, and 17 in other industrial pursuits. About 59 cases of anthrax infection were reported in different parts of Europe during the year 1905. Ravenal reported in three localities in Pennsylvania, during the summer of 1897, 12 cases among men and 60 in cattle, which were traced to a tannery handling imported hides from China. Nichols reported 26 cases occurring in persons employed in a curled-hair factory within three years. The General Government recognizes the dangers by insisting upon the exclusion of rags, wool, and hides coming from infected districts during the prevalence of cholera, anthrax, and typhus fever and their proper disinfection at all times. While anthrax is not a very common disease among American domestic animals, local pustular infections and carbuncle are by no means infrequent, and might well be guarded against, as in some of the European countries, where recourse is had tc disinfection of the raw material, special blower apparatus for the removal of dust, repeated disinfection of the premises, and prompt treat- ment of all slight wounds and abrasions. The material from which paper is made includes rags, burlap, old paper, and wood pulp. The rags are chiefly imported from foreign countries, arriving in a baled condition, and after opening are sub- !The State of Maine requires evidence of successful vaccination in persons engaged in the rag industry or those employed in the manufacture of paper from foreign and domestic rags. 31 jectcd to a number of processes for the purpose of cleaning and dis- integration. The "beating, thrashing," and "chopping" process is carried on by machines and is attended by the e cape of more or lesi dust. The quantity naturally varies with the < leanline of the itock. In the observations of about 80 establishments, the Massachusetts Board of Health found that with the usual grade of stock, no matter what kind of "duster" or "thrasher" is used, a considerable amount of dust is also evolved in the "chopping" process, and in spite of exhaust fans and dust pipes some dust will escape. The men engaged in the collec- tion and baling of this dust are usually provided with respirators. In a majority of the mills visited a proportion of the employees are exposed to an excessive quantity of dirt, dust, and lint, and in most of this majority the persons so exposed show not a few who are pale and sickly in appearance. A comparison of the death rate from tuberculosis, pneumonia, and bronchitis at Holyoke, the center of this industry in Massachusetts, with those of the State at large, showed "that the Holyoke rates were under rather than over the average." 1 OCCUPATIONS INVOLVING EXPOSURE TO POISONOUS DUST. LEAD DUST. All occupations in which lead is employed and in which particles of lead may be inhaled, swallowed, or absorbed by the skin must be regarded as dangerous to health. Lead poisoning in its various forms, such as the lead habit, characterized by loss of weight, anaemia, sallow skin, a blue line along the gums, offensive breath, a sweetish taste and diminished salivary secretion, lead colic, "lead paralysis, wrist drop, painful affections of the lower extremities, and other grave nervous diseases, is frequently seen in artisans. It attacks persons employed in the roasting of lead ores, in the manufacture of white and red lead, acetate and chromate of lead, china and pottery, artificial flowers ; also painters, plumbers, varnishers, type founders, typesetters, file cutters, glass and gem cutters, electricians (especially those employed in charg- ing storage batteries), persons engaged in enameling, dyeing, printing, working in rubber goods, weighted silk, and glazing of paper, and many other occupations involving the employment of lead. Doctor Teleki, of Vienna, in 1906 reported several cases of lead poisoning in females and young girls, contracted in fringe making, the silk having been weighted by a solution of sugar of lead. 'Report of the State Board of Health of Massachusetts upon the sanitary condition of factories, workshops, etc., 1907. 32 Of 999 employees in Prussian lead smelters during the year 1905, 177 suffered from lead colic or lead palsy, involving 3,056 days' loss of work; and of 4,789 engaged in zinc smelters, 50 of the employees, with 2,217 days' loss of work, were thus affected. In Europe a most marked reduction in the morbidity and mortality has taken place during the past ten years, coincident with the enforce- ment of preventive measures. The number of cases of lead poisoning in England, where report is compulsory, has been reduced from 1,278 cases in 1898 to 592 cases in 1905. While most of the cases occurred in sugar-of-lead works and potteries, a considerable number were also reported in the other occupations already referred to. The percentage of severe cases in men was 23.9, as compared with 13.9 in females — perhaps because the latter have cleaner habits and possibly also stop work more promptly upon the appearance of the first symptoms. In Paris it is estimated that over 30,000 persons are engaged in occupations involving exposure to lead, and of the 14,000 painters and varnishers employed there an average of 250 are treated annually in the hospitals for lead poisoning. File cutters are not only subjected to an irritant dust, but also to lead poisoning, because the file in cutting is being held upon a leaden bed "and particles of lead are inhaled with the dust and may also be absorbed by the fingers in handling the stiddy." The mortality figure for plumbism, in 1890-1892, was no less than 75. 1 The greatest danger in lead works is from inhalation of the lead dust and fumes ; hence a special spray apparatus and exhausters have been designed, and employees have been taught to protect their hands with gloves and the mouth and nose with respirators. In the pottery industry, where the danger arises from the glazes, the flux being made of litharge, clay, and flint, it has been found that the danger can be very much reduced by using only 8 per cent of car- bonate of lead in the form of a "double-fritted silicate," instead of the older method, in which from 13 to 24 per cent of lead carbonate was employed. Smoking should be forbidden during the working hours, and the work should be done in a special suit, frequently washed. The hands, face, and nostrils should be thoroughly washed with soap and water upon cessation of work, and the mouth and throat rinsed with a watery solution of tartrate of ammonia before eating and drinking. The same rules are applicable to painters, who would likewise find it of benefit to soften old paints with an alkali (weak lye) before scraping and to keep the handles of tools clean from deposits. 1 Dangerous Trades, Oliver, 1902, p. 138. 33 THE LEAD INDUSTRY IN MASSACHUSETTS. The report of the Massachusetts Board of Health 2 gives a very complete account of the conditions which obtain in the manufacture of lead compounds in the several factories visited. "The men who attend the grinding machines arc of a very different class from those who empty the stacks, and since they are not exposed to lead dust they do not suffer from lead poisoning and are comparatively healthy. Those who empty the stacks do not remain long at work. It is said that this is due in part to the disagreeable nature of the work, in part to the fact that they are largely roving characters, who do not care to work more than a few days occasionally, and in part to the fact that they acquire lead poisoning and are obliged to quit. Even those of good intentions rarely work more than a month." One establishment is referred to where white lead is made by the "wet process," with no evolution of dust, and there is no history of lead poisoning. In a "red-lead" factory, also, the general process is commended, especially the absence of appreciable amounts of dust, and the intelligence of the workmen, who are mindful of the dangers and who, with an experience of 6 to 25 years, appear well and strong. In one of the lead-oxide works more or less dust escapes into the air during the transfer to the mill and packing it into barrels. The men wear respirators, and each man washes carefully and changes all his clothes before leaving the establishment. In another establishment "all of the 40 employees appeared to be in good health, and the con- ditions everywhere were found to be commendable." In the lead-pipe and plumbers'-supplies factories the lead fumes are carried away by hoods and exhaust pipes, and in no instance was it possible to trace a case of lead poisoning to faulty methods. All of the employees observed the necessary precautions and appeared to be in good health. In the manufacture of solder the same precau- tions are employed, and although in the establishment described, rats. cats, and dogs appear to succumb to lead poisoning, only one case of lead poisoning occurred among the employees in 35 years. In the pottery industry it is said that lead poisoning is almost unknown in the six establishments visited ; only two cases occurred a few years ago in girls who applied the glaze. A possible explanation for this gratifying contrast to conditions observed in French and English potteries may be found in the fact "that the persons engaged in this industry appear to be of good intelligence and understand thor- iPage 99- 34 oughly the importance of care and strict personal cleanliness, and that the employers provide ample means for its maintenance." Wire and wire-cloth making as carried on in some of the plants visited in Massachusetts appears to be attended, in the opinion of Doctor Hanson, 1 by "avoidable dangerous conditions." "After the wire is hardened by being run into crude oil, it is passed through ket- tles of molten lead inside the tempering furnaces and is then finished and wound for shipment. From the tempering furnaces dense blue fumes arise and envelop the men whose work it is to feed and tend them. Occasional cases of lead poisoning occur in this department. In. one establishment one of the employees of 5 years' experience shows the characteristic blue line of lead poisoning on the gums, and another of 14 years' experience, in the same room, has a history of 'wrist-drop' and other evidence of chronic poisoning. Efficient mechanical ventila- tion is most necessary in this work, but it is not always provided." 2 Doctor Hanson, evidently referring to the same factory, writes : "All of the employees in this room worked 11 hours a day and had irregular hours for eating. There were no rules concerning the duties of the employers or those of the persons employed in order to avoid this serious danger. On the contrary, the hoods and blowers and top ventilators for the lead and other fumes were found to be distinctly inefficient, and over one large furnace there was no protection of any sort, the appliances having been broken years before and none renewed, so that all the fumes mingled at once with the air of the room." In making shingle stains pigments like chromate of lead, zinc oxide, iron oxide, and Prussian blue are used, and in the two establishments visited the men appeared to be careless in the matter of handling the pigments. 3 In the manufacture of paints, colors, and varnishes much of the work is done outdoors by men who have worked from 6 to 20 years ; the man who makes the lead colors has worked 17 years without sickness. 4 The last cases of poisoning at this establishment occurred 16 years ago, when a number of inexperienced men were poisoned with Paris green. In a color and mordant factory where anilin colors, log- wood, starch, sodium dichromate, etc., are used, "about one in five of the employees is noticeably pale and sallow, and inflamed eyes were not uncommon." The latter condition is ascribed to the sodium dichromate. In the manufacture of "whiting" about half of the 58 men employed in three establishments visited "looked to be in poor condition." '"The effect of industry on health," Boston Med. Journal, No. 14, April 4, 1907, Wm. C. Hanson. 2 Report of the State Board of Health of Massachusetts, 1907, p. 91. 3 Page 106. 4Page 107. 35 PRINTERS, TYJ'E FOUNDERS, A XI; TYPESETTERS. The mortality of printers in England is high, being 1,096 per 10,000, as against 953 for all occupied males and 602 for agriculturalists.' According to Schuler, of 1,000 Swiss typesetters and founders, 304.7 are annually taken sick, and of printers 250. Diseases of the digestive organs predominate (78 per 1,000). Diseases of the respiratory pass- ages come next (75 per 1,000). Sommerfeld states that among 38 occupations tabulated by him the printers occupy the fifth rank in the number of deaths from tuberculosis. Albrecht reports that the statis- tics of the Berlin Sick Benefit Insurance Company covering a period of ^ years show that 48.13 per cent of the deaths among printers are caused by consumption. 2 This may be due in part to the fact that many weaklings engage in this occupation, but the work itself is often performed in most unfa- vorable environments and in an impure and dusty atmosphere, which has been found to contain traces of lead, arsenic, and antimony. Spe- cial attention should be paid to proper ventilation, and particularly to the collection and removal of dust from the type cases. One gram of this dust has been found to contain 57.7 mgr. of lead, 186.8 mgr. of antimony, and traces of arsenic 3 Strasesr has suggested a type case with perforated tin bottom which is placed within another case, so as to facilitate the collection and proper disposition of this injurious form of dust. A recent study of the "Health of Printers" by George A. Stevens, in the Twenty-fourth Annual Report of the Bureau of Labor Statistics of New York, based on the records of the International Typographical Union and the London (England) Society of Compositors, shows clearly the very high death rate from tuberculosis among printers. The following table gives for the years 1901 to 1905 the annual death rates per 1,000 from the leading causes and from all causes among compositors in certain localities. tDangerous Trades, Oliver, p. 151. 2 Roth Kompendium der Gewerbe-Krankheiten. Berlin, 1904. p. 56. 3Rueszahegyi, Archiv, fuer Hygiene. III. p. 522. 36 ANNUAL DEATH RATE PER t.ooo FROM PRINCIPAL CAUSES AND ALL CAUSES AMONG COMPOSITORS IN CERTAIN LOCALITIES, FOR THE FIVE YEARS 1901 TO 1905. ' [From Twenty-fourth Annual Report of the Bureau of Labor Statistics, 1 906.] Death rate per 1,000. £ « •£°° .2 "2 >» J a! 9 g - a 5 O « O (A ™ .. U c >> s - £ «.~ "> a a C u be u B O *j .„ >> s « s « • u.2 -i •5 "i 13 C must be insured. By special regulations this requirement may be extended to agricultural and household employees. To secure the enrollment of individuals "for J The writer is indebted to these sources for much of the information on this subject and gratefully acknowledge this indebtedness. 88 sick benefits," the employers in the industries subject to the law are re- quired to send to the proper insurance fund the names of each person who enters or leaves their service. The income of the sick funds is derived from the dues of members — the amount is fixed by each local association, but cannot exceed 6 per cent of the members' wages. The employee pays two-thirds of the dues and the employer one-third. The employee's share is deducted from his wages and paid direct to the insurance fund by the employer, when he remits his own share. The benefits offered by the sick funds vary in amount, but all of them are required to provide the following as a minimum: I, Free medicine, attendance and treatment ; 2, In case the sickness causes ina- bility to work, the fund pays a sick benefit equal to one-half the wage rate which was used in calculating the member's dues. This benefit begins the third day after the disability sets in, and continues for 26 weeks. Instead of receiving medical treatment at home a member is entitled to treatment at a hospital, in which case an amount not exceed- ing one-half of his daily wage is paid to his dependents. Female mem- bers receive similar benefits for a period of six weeks following con- finement. 3, In case of death, a funeral benefit equal to twenty times the amount of his daily wage is paid to the heirs of a member. In 1904 there were 22,912 local sick and miners' provident associa- tions in the German Empire with 11,400,000 members, practically one- fifth of the population. The disbursements amounted to 237,107,000 marks (about $56,470,000). Of this amount 106,000,000 marks (about $25,238,000) was paid for sick benefits and the remainder for medical and hospital treatment, convalescence and funeral benefits. Accident Insurance. — Under the provisions of the laws of 1884, 1887 and 1900 all workingmen and technical experts engaged in industry, agriculture, forestry, transportation and coast fisheries earning less than 3,000 marks (or about $715.00) per annum are required to be insured against accident. By special enactment it may be extended to foremen and petty employers with more than 3,000 marks income. This form of insurance is administered by associations of employers known as "mutual trades associations," subject to Federal supervision. In 1904 there were 114 associations, including 5,300,000 establishments and 17,500,000 workmen. The workingman's share of the expense of the accident insurance consists of the benefits paid out of the sick insurance fund to the injured person during the first thirteen weeks of disability. The share of the employer is determined from the amount of his pay roll and the danger rate of occupation. Beginning with the fourteenth week the trades association provides: I, Free medical treatment; 2, A 8g pension during the continuation of the disability, whether the disability is partial or complete. In case of complete disability the pension is equal to two-thirds of the earnings of the injured per on; in case of partial disability the insured receives a fraction of the above pen proportioned to the degree of disability. In case of a fatal accident, the law provides for: I, A funeral benefit of not less than $12.00; 2, A pension to the dependent of the deceased, including parents, beginning with the day of death. The widow and each child up to the age of 15 receives 20 per cent of the earnings of the deceased, though the sum of these pensions may not exceed 60 per cent of such earnings. Premiums paid in 1904 were $35,592,000.00; disbursements, $30,- 552,000; viz., to 758,392 injured members, to 65,503 widows, 97,246 children, and to 3,647 parents of those killed. Invalid and old age pensions were made compulsory under the Ger- man law of 1889 (revised in 1899) for all wage-earners with an income of less than $480.00 per annum ; the provisions may also be extended to include petty employers and persons in household industry. The in- valid pension is paid without regard to age to those persons whose earn- ing capacity has been permanently reduced to less than one-third. The pension is also paid to those who have been in a state of disability for 26 weeks and continues as long as the disability lasts. To be eligible for this pension, the insured person must have been a member of the "in- surance institute" for 200 weeks, during which time not less than 100 payments of weekly dues must have been made. If the disability has been incurred purposely the right to a pension ceases and the offender is liable to criminal prosecution. In addition to the pension from the "insurance institutes" the Em- pire grants a stipend of 50 marks (about $12.00) per annum to invalids, as well as persons over 70 years of age. Members are divided into five classes on the basis of wages received. Each class pays a different rate of dues and receives benefits in propor- tion. The lowest invalidity pension granted is $27.70, the highest is $107.10 per annum. The dues range from 3 1-3 cents per week, accord- ing to the wage-class in which the member is enrolled. One-half of the amount is paid by the employer and one-half by the employee. The old age pension is paid without regard to earning capacity when the seventieth year of age is completed. Members must have paid dues for 1200 weeks before they become eligible for such a pension. In 1904 there were 40 invalid pension organizations, with 13.8 million insured members. Premiums paid in $36,960.000 ; disbursements. $35,520,- 000. The average invalid pension is $37.20. and the old age pension $37.68, varying in amount with the wage-class. 90 The financial soundness of the system is secured by making the em- ployers, the guilds and parishes eventually responsible for any deficit in the various sick insurance organizations. The national, State and local governments guarantee the payment of claims against the accident and invalidity insurance organizations. Synopsis of practical results. The financial status of the working- men has been improved at least to the extent of the benefits received from the amounts contributed by the employers and the government. Experience has shown that employers have not deducted their share of the dues from wages. The hygienic conditions of the workingmen have been improved, both on account of the safeguards which the accident insurance organi- zations require employers to use and because of the special efforts made by the "sick funds" to reduce the sick rate among the members to a minimum. The general knowledge in regard to the preservation and promotion of health, which the "sick fund organizations" have dissem- inated by means of circulars, monographs, popular lectures, etc., have exerted a tremendous educational influence in the promotion of health and morals. One of the most beneficent features of the entire system has been that parts of the funds of these organizations are invested in model-houses, hospitals and sanitoria for the use of members. The writer, during his visit to Berlin in the autumn of 1907, had occasion to inspect some of these workingmen's houses, as well as the most complete and elaborate sanitorium in the world, at Beelitz, near Berlin. The object of this is to provide the very best facilities for the speedy re- covery and the restoration of earning power of the industrial wage-earner. Dr. Bielefeldt (Med. Reform, 15th Jahrg, 1907, page 238) calculates, that in the treatment of 159,802 tuberculous patients, between 1897 and 1906, the net gain in spite of an expendi- ture of fifty-six million marks amounted to more than four and one-half million. It is interesting to note, that the Prussian "in- surance institutes and sick funds" in 1907 alone maintained 28 hos- pitals and sanitoria, the latter chiefly for consumptives and convales- cents. One of the latest features was the establishment in 1902 of a special hospital for sexual diseases in the male, at Lichtenberg, near Berlin, and a sanitorium for nervous and anaemic female wage-earners in Pyrmont (Hannover) ; all upon the principle that it is in the highest degree good economy to restore as speedily as possible the unproduc- tive to the ranks of the producers. Some conception of the good work may be found by a brief description of the sanitorium at Beelitz, which was erected in 1902 by the "insurance institute" of Berlin at a cost, according to report of Directors, June, 1907, of 15,287,994 marks. 9i Average number of patients, 41^5 male and 203 females; number of cases treated in 1906, 4,192; number of hospital days, 212,457; expense for 1906, 1,470,062.25 marks, or at the rate per capita per day of 6.92 marks. One portion of the institution is devoted to the treatment of incipient cases of tuberculosis; another, and entirely detached depart- ment, to cases of every description requiring high-grade sanatorium treatment in order to prevent premature invalidity. Each of the hand- some and spacious pavilions accommodates 200 male or [00 U ' apart from these are four porter's lodges for the four departments under separate enclosures, I general administration building, I central power and heating plant, I central bathing establishment, 1 disinfecting plant, 3 pumping stations, kitchen, laundry, workshops, quarters for medical offi- cers, employees, bowling alleys, hothouses, stables, etc. The hospital staff consists of 10 physicians and 128 employees. The writer was informed, in September, 1907, that since the estab- lishment of the '"sick funds" and "insurance institutes" in Germany, poverty has decreased and the number of patients treated wholly at public expense has markedly diminished, as workingmen even of the humbler classes prefer to devote their sick benefits to hospital care, rather than be a charge upon the parish or country. INCOME, EXPENDITURES, AND INVESTED FUNDS OF THE INSURANCE SYSTEM Items. Sick insurance, 1 90 1. Accident insurance, 1902. Old-age and invalidity insurance, 1902. Total of all insurance, 1885 to 1901 Dues of employers Dues of employees Subsidy of imperial government. Interest and other income Total income Expenses for relief.... Cost of administration. Total expenditures Invested funds M3. 952, 723 31,126,584 2,604,130 $29,907,868 3.743.936 $16,539,308 16,539.308 9,008,227 8,054.310 $508,445,565 487,147,059 51,049,907 93,588,044 47.683,437 33,651,804 50,141,153 1,140,230.575 43.595,450 2,590, S37 25,735.679 3,965,983 28,658,559 2,843,541 755.oi5.72o 79.993,721 46,186,287 29,701,662 31,502,100 835.009,441 44,421,557 I 47.408,235 I 239,779,652 I 309,020,248 Effects of the Insurance System on the Employer and Consumer. — The foregoing table shows that the system has materially added to the financial burdens of the employer, but it is believed that they have not been too heavy, at least they have not injured Germany's ability to com- pete in foreign markets. One authority estimates that the amount paid by the employer for accident insurance is 3 per cent of the wages, for sick insurance i l / 2 per cent of the wages, and for old age and invalidity insurance, 1 per cent, or a total of $y 2 per cent of the wages added to the cost of production. 9 2 Dr. Lass, of the Imperial Insurance Office, concludes, however, that this burden has not been shifted to wages, nor has it resulted in higher prices tc the consumer, but has been made up by improved methods of produc- tion. The writer has purposely devoted much space to the German in- dustrial insurance system, because he realizes that sickness and funerals are the most potent causes of poverty and distress ; he knows from per- sonal knowledge that prior to 1883, Germany depended upon employers' liability laws, charitable organizations and private companies for the protection of her wage-earners, with very questionable results. While much has been achieved in other directions for the prevention of disease, the most distinct gain in social-political endeavors was made by the en- actment of these laws, and especially the law of June, 1889, authorizing "insurance institutes" to invest part of their funds in hospitals and sanitoria, thus affording the best possible facilities for the speedy re- covery and the prevention as far as practicable of permanent disabilities. According to Zacher (Leitfaden zur Arbeiterversicherung des Deutschen Reiches, 1906) quoted by Professor Henderson, "at the end of 1905 in all 70 million pensioners (sick, injured, invalids and their de- pendents) had received $1,200,000,000 in benefits. The workmen have contributed less than one-half of the premiums, and have received $480,- 000,000 more than they have paid out. Property is owned to the amount of $408,000,000, of which $120,000,000 have been invested in workmen's dwellings, hospitals and convalescent homes, sanitoria, baths and similar institutions of welfare." There is no pauperization in a method where the beneficiary contri- butes such a large share to the undertaking. As a matter of fact, meth- ods in vogue in our own country are calculated to shift all of the burden upon the tax-payer. For a more complete exhibit, the following tables are reproduced from Professor Henderson's article in Charities, December 7, 1907 : Sickness Insurance (since 1883) Marks Sickness payments 1,114,629,489 = 1267,500,077.36 Physicians 514, 803, 920 = 5123, 552, 940. 80 Medicines, &c 402,757,651=$ 96,661,836.24 Hospitals 303,061,148 = $ 72,734,675.52 Death benefits 83,763,839=$ 20,103,321.36 Lying-in-women 36,543,672 = $ 8,770,481.28 Various benefits 38,414,074 = $ 9,219,377.76 1888-1904 $ 2, 493, 973, 763=$598, 553, 710.32 1905 250,000,000 = $ 60,000,000.00 In round numbers 2,744,ooo,ooo = $6s8,56o,ooo.oo 93 Accident Insurance (since 1885) Marks A 1 'Ml. ill l.i in lil 759.172,928 -$182,201 ,502.72 Payments i<> dependenti "i diseased '01,777,557- 3 Medical care 171*84 l [ospitals I leal ii bi in His Widows 7.7't7.57" -$ I 1 ligneri 3.846,489 $ 603, 157.36 1885-1904 i,057,758 ( 58s = $253,862,o6o.40 J 905 [36,000,000 ; in round numbers 1,194,000,000 — $286,56 Invalid and ol,l age pensions (since 1 89 1 ) Marks 1 11 v.i l ill pensions 560,486,961 =1134,5 16,870.64 ( )ld age illusions 336,472,378=$ 80,753,370.72 Medical care 55.37'. 747==$ >3.389.2'9-28 Return of premiums (a) at marriage 38,025,117:=$ 9,126,028.08 Return of premiums (1>) al deatb 13,422,508 = $ 3,221,401,92 Return of premiums (c) at accident 171,201=5 41,088.24 1891-1904 1, 003, 949, 9I2 = $240, 947, 878.88 1905 162,000,000=$ 38,880,000.00 In round Humbert 1,166, 000, 000 = 5279, 840, 000. 00 It is sincerely hoped that the wage-earners of this country may profit by the experience elsewhere, by the adoption of a similar system, and thus avoid the dangers and losses to which they are now so frequently subjected by unscrupulously managed insurance concerns. There appears to be no good reason why the National Government should not inaugurate such a system for its own employees. In this connection it may be well to refer to a most successful precedent in the establishment of the United States Soldiers' Home in Washington. This institution was founded in 185 1 with $100,000.00 paid as indemnity by the city of Mexico. Every soldier is taxed at the rate of 12^ cents per month, which is deducted from his pay. This together with the fines from courts-martial and forfeited pay from deserters is turned into the treasury of the home. The home now owns property costing over $2,500,000.00, accommodates 950 inmates, pays a commutation at the rate of $8.00 per month to soldiers having dependents and unable to avail themselves of the privileges of the home, amounting to about $20,000.00 a year, and still has a reserve fund of about $4,000,000.00. WHAT THE EMPLOYER MAY DO FOR THE WELFARE OF EMPLOYEES. It has been stated at the outset that social betterment cannot be dis- associated from industrial betterment, and it is here that the employer can do much for the welfare of his employees. Apart from a cheerful compliance with the laws and ordinances which may, from time to time, be enacted for the protection of the working classes, it is clearly the duty of the employer to promote in every way the efficiency and earning 94 power of the wage-earner and to pay such wages as are necessary to improve the standard of living among poorly paid employees. There is no doubt that thoughtful employers generally realize that they are not only responsible for the proper technical training of appren- tices, but also for their habits, and a gratifying number of establish- ments have made every effort to surround them with all possible chances for improvement, mentally and morally. There is a class of youthful employees, both males and females, for whom the writer begs to enter a special plea ; they are entitled to every consideration, because, either as a result of inheritance or faulty environments they have acquired a general inaptitude ; they are perfectly willing to work, but awkward in all their movements — simply do not know how to work — and soon ex- haust the patience of their instructors. Such persons are found seeking to make an honest living in nearly all occupations, and while they may be better adapted to some employ- ments than others, to discharge them without a fair trial means their utter ruin. Here appears to be a field for human sympathy, and special pains should be taken to teach them, by patient fellow workmen, how to handle tools and work to better advantage, whether it is with the pick or shovel, at the ploughshare, the street or house broom, or in the diversified employments of artisans' workshops. Industrial Betterment. — Space will not permit to enter into details concerning efforts which have been made at home and abroad in the promotion of the general welfare of the working classes. At a meeting of the American Social Science Association, held in Washington, April 18, 1901, Mr. J. H. Patterson, Dayton, Ohio, read a paper on factory sanitation and described a large manufacturing plant of which he is the head, and their close adherence to the principles of hygiene and the up- lifting of mankind. The interior of the factory is painted in cheerful colors, extra windows were made to give light, forced ventilation to afford plenty of fresh air, and all dust and acid fumes are carried away by exhaust fans. Bathrooms and well furnished toilet rooms are on all the floors. All seats have backs. Clean aprons are furnished by the company, and a dining room where hot meals are served and a course in domestic economy is conducted. The grounds around the factory, and the houses of the employees, are healthful and attractive. "We have demonstrated," said Mr. Patterson, "that this system pays the employee, the manufacturer and the buyer, in the health of one, profit of the second, and the improved quality of the product purchased by the third." Bulletin No. 31, Department of Labor, November, 1900, contains an article on betterment of industrial conditions, showing what has elsewhere been accomplished, every effort being in the right direc- 95 tion. Among the most important may be mentioned ! i, The increasing of industrial efficiency through industrial schools and manual training classes; 2, The care for employees' health and comfort by mean of bathing facilities, gymnasiums, calisthenics, baseball, bicycle clubs, din- ing and lunch rooms, the furnishing of hot lunches free, or at cost, im- proved sanitary conditions and appliances ; 3, The improvement of do- mestic conditions by means of improved dwellings, instruction in sew- ing, cooking and housekeeping, in landscape and kitchen gardening, and the exterior and interior decorations of homes ; 4, The care of sick and disabled employees and their families by means of free insurance, medical attendance and hospital facilities and by the encouragement of beneficial organizations ; 5, Club organizations for social, recreative and intellectual purposes by means of free lectures, libraries, kindergartens and educational classes, social gatherings, summer outings, meeting places, game rooms, banquets, dances, etc. ; 6, The encouragement of musical and dramatic clubs and the promotion of spiritual life by means of Sunday-schools and general religious work; 7, The cultivation of thrift through savings bank facilities, building associations, or provident organizations, rewards for valuable suggestions of employees, for faith- ful service or the manifestation of zeal and interest in their employ- ment; 8, The promotion of employees' personal interest in the success- ful conduct of the business by encourgaging and assisting them to purchase shares, financial aid to employees in case of unusual hard- ships and distress, and the cultivation of cordial and even confidential relations between employer and employees. (For details consult Bulletin of the Department of Labor No. 31, pages 1117-1156). It is gratifying to note that, although Washington is not an industrial center, a large number of firms have taken steps for the promotion of the general welfare of employees. WHAT THE GENERAL PUBLIC MAY DO. There is a tendency at present among young men, the sons of parents who have accumulated some means, to expect to live and grow rich without manual labor. It is becoming fashionable to look upon the mechanic with disdain, to consider manual labor degrading, an evidence of low breeding and all such nonsense. The young men want to be book-keepers, bankers, lawyers, doctors, or office holders, anything which does not involve manual labor, and expect their fathers to furnish the means to attain the goal of their ambition ; as a result the profes- sions are overcrowded and men fail who might have been successful in the handicrafts. Let us teach our children to respect and perform hon- 9 6 es* labor, whether it is behind the ploughshare, in the saddle, or in the workshops. It will teach them self-reliance, prudence and perseverance. It will be conceded, that the burdens of improving industrial and social conditions should not be carried by the employer and employees alone. There are many phases of vital importance frcm the standpoint of public health and humanity, which should concern every thoughtful man and woman. Reference has already been made to the appalling and dangerous conditions under which many of the trades and occupa- tions are carried on in tenement houses. While this is, in part, due to the greed of the manufacturer, because it means less factory space, less rent, light, fuel, and a decidedly smaller pay-roll, the consumer is equally to blame, because of his constant demand for cheaper goods, quite ob- livious to the fact that the garments may be a source of danger from in- fectious diseases, and are stained with the sweat and blood of help- less women and little children. During one of the Presidential campaigns, a clever orator referred to Glasgow and told us, that 41,000 of the 100,000 laboring families of that manufacturing center lived in one-room tenements, and that this one room for a family of father, mother, daughters and sons, told what the wages in Scotland were and how they dragged humanity down into bestiality and misery. We need not go to Glasgow for such illus- trations, for to our shame, it must be confessed, that similar condi- tions obtain in nearly every American industrial city. The effects of such conditions upon death rates will be presently referred to. In the meantime, it will be readily conceded that the people do not live a c a rule in such quarters from choice, but from sheer necessity. Low wages compel the working classes not only to find shelter in houses unfit for human occupation, but also affect their health and the health of their children by insufficient food and clothing, and last, but not least, it means the utilization of child and female labor in some of the most atrocious forms referred to on another page. Indeed there is much reason for assuming that low standards of living, which insuffi- cient wages tend to beget, play a very important role in physical, mental and moral degeneracy. "Physical health is the basis of mental health." This aphorism of Aristotle has been proved to be true by the experi- ence of every educator. Professor Dawson, in his study of youthful degeneracy (Pedagog- ical Seminary, vol. IV, page 2), found among the boys and girls in reform schools evidence of physical degeneracy as shown by lighter weights, shorter statures and diminished muscular power, and de- clared that 16 per cent of those examined by him were "clearly sufferers from low nutrition." It is to be hoped that the public conscience may be 97 Sufficiently aroused to insist upon adequate wages for all claSK , and that (lie producer and eonsuiner alike will be Willing tO a uiii'- this rc- spousihility, not as a matter of charity, hut in justice to the laboring classes. In the whole range of social betterment and sanitation, e pecially in our efforts to combat tuberculosis, no field affords better Opportunity for philanthropic work than the erection of sanitary homes for wage- carncrs, at reasonable rentals, the encouragement of cooking schools and the establishment of model lodging and eating houses. The York City and Suburban Homes Company has now for dividend dis- bursements 4.5 per cent a year on an investment of $5,500,000. The Washington Housing Companies have an investment of over one mil- lion, have paid respectively 4 and 5 per cent from the very inception of the companies, and have a surplus fund of over $100,000.00. London has more than $100,000,000 invested in model tenements. Houses for IVagc-earncrs. — The housing of the working classes has very properly been made the subject of legislation in many countries, and is a matter in which factory owners, labor unions and the general public should be deeply and mutually interested. There are several sys- tems of dwellings for artisans and laborers, viz., individual houses or cottages, a row of houses under one roof, and the so-called "flats." Preference should be given, when practicable, to the cottage system, but in large cities unfortunately the value of real estate frequently compels the erection of large tenements, and in such an event the State should insist upon hygienic requirements as regards air space, light and ventilation. No home can be considered sanitary where one room has to answer the purposes of a living room, sleeping room and kitchen, or where the water-closet or privy is used by. more than one family. Evil Effects of Insanitary Houses and Overcrowding. — The primary object of habitations is to secure protection from the influence of heat, cold, rain, sunshine and storms, and thus promote the health and happi- ness, and indirectly also, the morals and culture of the human race. The influence of sanitary houses can not be overestimated. Dr. Villerme, in an investigation in France from 1821 to 1827, found that among the inhabitants of arrondissements containing 7 per cent of badly constructed dwellings, 1 person out of every J2 died ; of inhabitants of arrondissements containing 22 per cent of badly constructed dwellings. 1 out of 65 died, while of the inhabitants of arrondissements containing 38 per cent of badly constructed dwellings. 1 out of even' 15 died. With the present rapid transit facilities in every citv. our voice should be clearly in favor of individual homes ; and when this is im- practicable, we should insist on broad streets and deep vards. Xo 9 8 more than 68 per cent of the lot should be covered by the house, and the height of the building should never exceed the width of the street. The baneful effects of tenement-houses should be avoided, as infectious diseases are more liable to spread in consequence of aerial infection and the more intimate contact of the occupants. Apart from structural defects, there is no doubt that the death rate is largely determined by the number of occupants to a room. Russell has shown that in Glasgow, when the average number of per- sons to each room was only 1.3 1, the mortality was 21.7 per 1,000, and when the number of occupants amounted to 2.05 for each room, the mortality reached 28.6 per 1,000. According to Korosi, the mortality from infectious diseases at Budapest is only 20 when the number of occupants to each room does not exceed 2, but is 29 per 1,000 with 3.5 occupants, 32 per 1,000 with 6.10 occupants, and 79 per 1,000 when there are more than 10 occu- pants to each apartment. The death rate at Berlin, in 1885, among the 73,000 one-room ten- ants was 163.5 P er 1,000, against 5.4 per 1,000 among 398,000 resi- dents occupying four-or-more-room apartments. 1 The analysis of 2,701 infantile deaths in Berlin during 1903, investigated by Neu- mann, has been presented elsewhere in this work. Insanitary dwellings are to be found everywhere, and particularly in older cities erected at a time when the principles of sanitation were comparatively unknown. One of the most important municipal prob- lems is to correct existing evils by the enactment and enforcement of suitable laws. It requires, however, a strong public sentiment to bring about a complete and satisfactory reformation, as evidenced by the housing movement elsewhere, for in spite of the excellent tenement- house laws in New York, according to Homer Folks, of 370,000 dark rooms reported in existence by the De Forest Tenement-house Depart- ment in 1903, some 20,000 only have been opened to the light during the past 3^4 years. The prohibition against the use of cellar and basement rooms partly under ground cannot be enforced, owing to the lack of a sufficient number of inspectors. The notorious "Lung Block" continues to contribute its horrifying quota to the annual mor- tality. (Charities, November 30, 1907). The writer has no hesitation in declaring that the housing condi- tions of the least resourceful of people have been, and are even now, more potent than any other factor in helping to swell the frightful mortality from consumption and other so-called house diseases en- gendered by unwholesome environment. House Diseases. — It has long been known that rickets, scrofula 'Town and City, Jewett, p. 14. 99 and other chronic forms of tuberculosis arc especially prevalent in dark, damp and insanitary houses. The children arc ann-mic and as puny as plants reared without the stimulating effect of sunlight Add to this the fact that dampness abstracts an undue amount of animal heat, lowers the power of resistance and favors the develop- ment of catarrhal conditions, which render the system more vulnerable to tuberculosis, and we have a reasonable explanation why these diseases prevail, especially in basements or houses below grade and otherwise unfit for human habitation. The death rate is often double and treble that of other localities, and while there are doubtless other factors which determine the frightful mortality, none are more potent than deficient sunlight and ventilation. Diphtheria, cerebrospinal meningitis, acute and chronic rheumatism, and bronchial affections are also more frequent in insanitary dwellings. That the siftme is true of infantile diarrhoea, is doubtless due to the fact that the construction of the buildings does not protect from the heat of summer, and the enervating effects of heat and the more speedy decomposition of food (especially of milk), in such an atmos- phere, combine to carry on the slaughter of the innocents. The existence of disease-breeding habitations is a reflection upon Christian civilization, and there should be sufficient human sympathy to provide decent, healthful homes for our wage-earners, who consti- tute, after all, the bone and sinew of the country; and this is one of the occasions when we may well act as our brother's keeper. The history of improved dwellings reveals everywhere a lessened death rate, and the experience of the Washington Sanitary Improve- ment Company is equally gratifying. During the year ending Decem- ber 31, 1906, the apartments were occupied by 778 adults and 380 children, total 1,158; births, 39 and only 16 deaths, 10 adults and six infants, a death rate of about 13.7 per 1000 — which, with all due al- lowance for the average age of the occupants, shows a remarkably low mortality, when compared with the general death rate among the white population of 15.16 per 1,000. The regeneration of the housing conditions for the least resource- ful people is the great sanitary and social problem of the twentieth century. Take away the hovels and filthy places, let sunshine and pure air circulate through their homes, and teach them habits of cleanliness and responsibility, and the first step towards the elevation of the degraded and the education of the ignorant will be taken, not only in the war- fare against tuberculosis and other diseases engendered by insanitary surroundings, but also in the battle for higher moral and social standards. IOO Lodging Houses or Homes for Wage-earners. — Those who have read "The Long Day" cannot fail to be impressed with the just criti- cism of our present system of homes for working girls. The author makes a strong plea for homes designed after the Mills Hotels for working men ; no charity, but so built and conducted that they will pay a four per cent rate of interest upon the money invested. "A clean room and three wholesomely cooked meals a day can be fur- nished to working girls at a price such as would make it possible for them to live honestly on the small wages of the factory or store. We do not ask for luxuries or dainties. In the model lodging house there should be perfect liberty of conduct and action on the part of the guests, who will not be "inmates" in any sense of the word, so long ~s the conventions of ordinary social life are complied with." It is to be hoped that her simple but truthful story will be read And her appeal for industrial and social betterment answered. So long as the conditions described in the book exist, so long will it be wicked to rear magnificent and costly church edifices, and in this re- spect Christian civilization, which should be a strong factor in up- lifting and regenerative influences, has been remiss in its sacred obli- gations. To supply the needs spoken of, together with the establish- ment of cooking schools and kindergartens, so that the children of toil may at least have an opportunity to learn to work intelligently, may be regarded as a suitable field for practical Christianity, and would do much towards narrowing the breach which now exists between the church and wage-earners, and between capital and labor. Food for the Working Classes. — While the character and variety of food now served is very much better than it was fifty years ago, it is not what it should be, especially in lodging houses. The chief faults consist in improper cooking and the widespread error of con- suming a cold dinner from the lunch basket or dinner bucket. The art of cooking and how to supply good wholesome food and in proper quantities should be made the subject of popular instruction. The "Ladies Sanitary Association of England," deserves credit for having taken this matter in hand, especially since experience teaches that nothing prevents the abuse of alcohol so much as a sufficient and palatable supply of food. The establishment of public kitchens and eating-houses for un- married laborers, conducted upon practical sanitary and economic principles, would prove a great blessing; the same may be said of lunch rooms, where rolls, sandwiches, a cup of coffee, tea, milk, hot soups, etc., may be obtained at a nominal cost, and which would ma- terially lessen the evils of intemperance. 101 Since coffee and tea allay thirst, and arc Stimulants, without the depressing effects of alcoholics, there is no reason why factories and workshops should not supply these beverages at noon to employ at actual cost. The subject of food and cooking will be discussed in a special paper. WHAT THE EMPLOYEE MAY DO TO CONTRIBUTE TO HIS OWN WELFARE. Sufficient has been said in the preceding pages to indicate the dangers to which the working classes are exposed in many industrial pursuits, and the methods proposed to alleviate the effects have also been pointed out. It must be conceded that all remedial efforts have been prompted by the true spirit of humanity and as a social duty; hence it is reasonable to expect that wage-earners should show a willingness to avail themselves of the various "safety devices" and not underrate their importance in the protection of life and limb. While it is criminal for employers not to provide suitable protection, it is equally culpable on the part of the operatives to disregard all such preventive measures. So, for example, it is not a pleasing reflection to be told by Dr. Harrington, professor of hygiene at the Harvard Medical School, in speaking of respirators, that "Aside from the dis- comfort caused, the operatives have another and a senseless objection to their use ; women complaining that they are made to look ridiculous, and men being moved to discard them by the gibes of their more reck- less fellows." During the past two weeks, the writer visited Frank- ford arsenal and found men working in high explosives without rubber gloves and respirators, although provided by the Government. (See page 21 ). Dr. Farrand, Secretary of the National Association for the Study and Prevention of Tuberculosis, also spoke to me of the great difficulties he and others have encountered in New York and New Jersey, in inducing the operatives to give safety devices a fair trial. Part II.— PERSONAL HYGIENE. It is a matter of constant observation that families, even with a modest income, get along very well until sickness and death enters the once happy home ; and if these financial burdens and sorrow can be prevented, it is clearly our duty to do so, even if the "chief bread winner" is not himself incapacitated for work. For these reasons the writer offers a few suggestions along the lines of general and personal hygiene, with the hope that they may serve to diminish human suffer- ing and distress. In doing so. while utilizing his own lecture material, 102 he has not hesitated to avail himself of the valuable brochure by Pro- fessor Kalle and Dr. Schellenberg "How to keep well and capacitated for work," Berlin, 1907, because the subject-matter and general style i.< specially adapted for popular education. House and Home. — Special pains should be taken in the selection of living quarters, no matter how humble they may be, as they con- stitute our abode for the greater part of our life. With the excellent motor facilities, there is no reason why crowded tenements should be chosen, and preference should always be given to individual homes, or apartments, in not exceeding two-story tenements. The Germans have an old but true proverb : "Where the sun does not enter the doctor surely will," hence dark, gloomy and damp houses should be avoided ; mouldy spots on the walls or ceilings and a close musty odor indicate dampness, and cheap rents should prove no inducement to occupy such quarters. Leaky roofs and down spouts, or a pile of ashes against a brick wall, may keep the house damp, and the causes should be promptly removed. In all such instances, as well as in the occupancy of a recently constructed house, it is very desirable to dry out the house by heat and open windows. Since we know that the mortality from contagious diseases in- creases in proportion to the number of inmates of the rooms, hygiene requires that, even the most modest dwellings, should afford sufficient room to prevent overcrowding. Ventilation is always necessary, but open windows are especially indicated at night, as nothing can take the place of pure fresh air in small quarters. This may be effectively accomplished without the danger of draughts by opening the window in the bedrooms from the top, and those of the adjoining room at the bottom. Night air, contrary to popular opinion, is not unwholesome. The only danger is from mosquitoes, which should be excluded by proper screening of windows and doors. There are many families who properly insist upon having a sit- ting room or parlor, which is most commendable, if the bedrooms are large enough to afford 500 cubic feet of air space for each occupant. If they do not it is desirable, after proper airing of the larger rooms, to utilize them for sleeping purposes, for it must be remembered that the air of habitations is vitiated by the consumption of oxygen and the exhalation of carbonic acid. The airing of rooms is even more essen- tial in cold weather, because of the additional pollution by carbonic acid from light and fires. There are a number of families, unfor- tunately, who for various reasons are obliged to live, cook and sleep in one room, and for whom the question of fresh air is therefore of vital importance. Such families should not hesitate to avail themselves of 103 the benefit of fresh air, especially when medical science has demon- strated the advantages of fresh and even cold air in the treatment of consumption and pneumonia, provided the body is kept warm by suffi- cient bed clothes. Household dust is as objectionable in many respects as the dust of workshops, because dust and germs always go baud in hand. So, fof example, UfTelmann found, that while the outer air contained only 250 germs in 10 cubic feet; the air of his library contained 2,900; of his sitting room, 7,500; of his bed room 12,500, and the air of a living room of a workingman's family, as many as 31,000 germs. He a! demonstrated that they increased after disturbing the dust of the roottu by feather dusters or by slamming the doors, showing that they actualy cling to the household dust. If the dust should happen to contain the germs of tuberculosis, from carelessly expectorated sputum, or which may have been carried into the house upon the soles of foot- wear, bottom of skirts, etc., such dust may prove a source of danger, especially to children. House Cleaning. — For reasons just given, there should be no accu- mulation of dust in any part of the premises. Hygiene, therefore, condemns all carpets and interior finishes which serve as dust and germ traps, such as heavy cornices, elaborate mouldings of door and window frames, wardrobes, cumbersome draperies and unnecessary furniture. Hygiene, on the other hand, approves of neatly polished floors with small rugs, which can be easily taken up and cleaned out- side of the house, curves instead of cornices and angles, smooth and non-absorbent walls, instead of embossed wall papers, simplicity of fur- niture, closets instead of bureaus and wardrobes. In brief, everything which will prevent the collection of dust and germs, and facilitate their removal may be regarded as hygienic. So, for example, a plain, tinted, smooth wall, or the varnished wall papers, which can be cleaned with a damp cloth, or any smooth wall paper guaranteed to be free from arsenic, are in point of health superior to the embossed silk hangings and tapestries of the rich man's home. The object of house-cleaning is primarily to get rid of the dust and germs. In sweeping it is desirable, therefore, to open the upper win- dows, but to keep the door leading into the hall closed, so that the dust may not be wafted back into the house. The dusting should always be done with a soft, damp cloth, frequently changed. Under no cir- cumstances should the feather duster be used inside of the house, as it does not remove, but simply displaces the dust. If the cracks in floors have been neatly filled up, and the floors oiled or waxed, they can be cleaned with a damp cloth much more effectively than by the tiresome process of scrubbing, a drudgery to every neat housekeeper. 104 The kitchen, cooking and eating utensils need special care, as un- clean food and utensils are often the cause of cholera-morbus and diar- rhceal diseases. Captain Sanderson, in the Cook's Creed, published for the United States Army, in 1862, showed his sanitary acumen when he says : "Better wear out your pans with scouring than your stomachs with purging, and it is less dangerous to work your elbows than your comrades' bowels. Dirt and grease betray the poor cook and destroy the poor soldier." Every effort should be made to have clean and cool storage facilities for food, and all perishable food, especially milk for infant feeding, should be kept on ice whenever the temperature is above 60 degrees. Temperature. — The most healthful room temperature in cold weath- er is between 65 and 70 degrees, as overheated rooms predispose to colds, and should be avoided. When the house or apartment is heated by cast-iron stoves or other heaters, special care is necessary not to bring them to a red heat, as the very dangerous coal gas is liable to escape through invis- ible fissures in the plate and joints while the heaters are red hot. It is desirable to select a good-sized heater lined with fire clay, which will not have to be brought to a red heat, and at the same time fur- nishes sufficient volume of warm air. If the air is superheated, it acquires a peculiar odor, probably due to charring of organic dust; it also becomes very dry and irritating, owing to the rapid evaporation of moisture from the skin and mucous surfaces of the inmates, and in consequence is apt to produce catarrhal affections, conditions which do not prevail when care is taken, and provisions made for the evapora- tion of a certain amount of water. Coal oil or gas stoves cannot be recommended, unless provisions are made to carry off the products of combustion. The danger from fire, which is always a great calamity, should be reduced to a minimum by preventing the accumulation of combustible material on the premises, proper care of matches and instruction of the children. Coal oil, gasolene, etc., should never be used for kindling purposes ; there is always great danger from explosions, fire, and fatal burns by filling a burning lamp, or extinguishing the wick by blowing over the chimney, or using a lamp when the chimney is broken. Insects. — Special attention should be paid to the exclusion and destruction of house flies, mosquitoes and other insects, for apart from the discomfort produced, there is much reason for assuming that dis- ease germs may be conveyed by flies and mosquitoes, fleas, bed-bugs and roaches. Celli, 1 of Rome, in 1888, demonstrated that the germs of tuberculosis and other disease germs may retain their vitality after "A. Celli Boll. dell. Loc. Lancis, degli espedali di Roma, 1888. ">5 passing through the intestinal trad of flies. Spillmann 1 pointed out that flics caught while feeding upon the expectoration of a consump- tive invariably contained viable germs, and Hoffmann 3 nol only con- firmed these observations, but also found the germ . in the fly spots on the walls of a room occupied by a pthisical subject. The writer has declared it his opinion for years, that flies may carry the germs on their feet, from typhoid stools and infected sources, to the food and milk Supply, and in [8953 pointed oul a number of hou e infec- tions in this city which could not be explained in any other way. The experience of the Spanish-American war appears to have fully con- firmed this conclusion. In like manner, the germs of cholera and of the oriental pest have been disseminated by the house fly. The evidence that certain species of mosquitoes are the intermediate host of the germs of malaria and yellow fever, and that man may be directly inoculated by the sting of these insects is absolutely conclusive. The efficacy of measures for the extermination of mosquitoes, and their exclusion from houses by proper screening, has been abundantly dem- onstrated both at home and abroad. It is gratifying to know, that the mystery of yellow fever was solved by the work of Surgeons Reed, Carroll, Lazear and Agramonte of the United States Army, and Surgeons Gorgas and Keane have demonstrated the best methods for the prevention of yellow fever and malaria by waging an unceasing warfare against the mosquitoes. Poultry, pigeons and household pets, like dogs, cats and parrots, ought not to be kept in the rooms, as they contaminate the air, harbor insects and may even convey disease germs. Parrots suffer at times from a pulmonary disease, which is transmissable to man, while certain forms of skin disease and itch may be conveyed by dogs and cats. What has been said of the desirability of general cleanliness applies with equal force to the basement, cellar, attic, yard, outhouses, garbage cans, etc. There should be no accumulation of rubbish within or without the premises. Where no sewer connections exist, the out- houses should be kept in a clean condition, and the seats provided with lids so as to exclude flies. It is also a good plan to disinfect the vault or receptacle with chlorinated lime or fresh whitewash, etc. A good housewife can not only accomplish a great deal for the health, but also for the comfort and morals of the family. As indi- cated by our German authors, general order and neatness, clean, white, washable curtains, some potted plants and a few suitable pictures, 1 Spillmann and Hanshalter. Comptes rendus 105. p. 352. 2 Hoffmann Deutsche Med. Zeitung. 188S. Xo. 57. 3Report of the Health Officer, District of Columbia. 1895. io6 avoiding the loud chromos, and a cheerful and refined atmosphere will do much towards keeping the husband and sons from the saloons. As a matter of fact, much may be done to transform undesirable living quarters into healthful homes, while filth, neglect and slovenly housekeeping often convert even structurally good houses into verita- ble hotbeds for disease germs. So, too, persons with delicate con- stitutions may, by attention to the laws of health, attain to a good old age, while the physical giant by a reckless life soon undermines h's general health and goes to a premature grave. Care of the Skin. — The skin is supplied with a network of blood vessels and nerves, and is a sensory, respiratorv, execretory and heat regulating organ. As a sensory organ, it combines with the tactile functions, the power of perceiving impressions of warmth and cold. The respiratory functions of the skin are limited, to be sure ; neverthe- less, small quantities of oxygen are absorbed and carbonic acid is eliminated. Apart from this, the skin of an average adult eliminates through the sweat glands about 2% pounds of water a day. Human sweat contains about 2 per cent of solid constituents, mostly in the form of waste matter or impurities, and the odor varies in different regions of the body and in different races. The skin also secretes a fatty substance through the sebaceous glands. As the water from the skin evaporates, the solid matter remains upon the surface, combines with dirt, harbors germs and readily undergoes decomposition, which, apart from the disagreeable odors so characteristic of unclean persons, also tends to mascerate the skin and is liable to produce "galling or chaf- fing," pimples and boils. Last, but not least, the accumulation of this matter would natur- ally close the pores of the perspiratory and sabaceous glands and throw the work of eliminating the impurities upon other organs. A normal cutaneous function is doubtless of great hygienic im- portance, as shown by the occurrence of many diseases following its suppression, because in such an event, in addition to the retention of the waste matter in the blood, work is thrown upon the kidneys and other eliminating organs, and these, if already weakened, naturally break down. Since the functions of the skin depend not only upon its anatomical intactness, but also upon cleanliness and a proper tone of the cutaneous vessels and nerves, a rational culture of the skin demands : 1, That it should be freed regularly from the secretory products and particles of dirt; 2, That the cutaneous nerves retain their normal excitability or when impaired that they regain their tone; 3, That we assist the skin in its heat-regulating functions, so that it may not be io7 overtaxed. All of which may he accomplished by ablutions, hath and suitable clothing. Ablutions and Baths. — Regular and systematic ablutions with soap and water arc requisite for reasons already given, ami dally necessary when engaged in dirty work or exposed to poisonous dust In addition to the chemical effects of soap, vigorous friction with a brush may be employed, not omitting the finger nails, as disease germs have been found in nail dirt. The water used should not be too warm for the body, as this would relax the skin and increase the susceptibility to catching cold. If the bathing is not done in the bath tub, it will be well to wash and dry part of the body at a time. In any event the surface should be wiped dry and hard, especially the hair, since wet hair is calculated to pro- duce colds. It is always a good plan to wash the neck and chest with cold water, so as to harden the skin. We will now briefly refer to the different forms of baths.- The cold bath is usually taken in a tub or by means of a shower or needle bath at a temperature of about 65 degrees for adults. It should not last over 3 minutes. Cool baths vary from 65 to 80 degrees. Tepid baths are taken at a temperature of between 80 and 90 degrees, continued from 10 to 15 minutes. Warm baths vary from 90 to 100 degrees, and are generally employed for their cleansing effect. In addition, there are steam or Russian baths, the Turkish or dry hot-air baths, river and ocean baths, swimming pools connected with public baths, medicated baths, etc. Swimming baths are particularly useful, as they also afford an opportunity for muscular exercise, and as the temperature of the water is rarely above 80 degrees. Such baths are both cleansing and stimulating, and therefore an excellent tonic for the skin. All baths should be followed by a cool douche and friction with a rough towel should be employed until the skin is in a general glow. The value of bathing is so fully appreciated that the building regulations of this city compel a bathroom for every apartment offered for rent. No com- munity should fail to make provisions for public baths, both in summer and winter. The beneficial effects upon the health and morals of the least resourceful people cannot be too strongly emphasized. The old Roman baths were prominent features of the daily life of the Romans, and were counted among the choicest privileges. Eleven large and 826 smaller public institutions adorned the ancient capital during the Diocletian period, and the baths of Caracalla. the ruins of which can be seen today, could accommodate 1,600 bathers at one time. The following sensible rules on the subject of bathing have been issued by the English Humane Society, and are well worth observing io8 by bathers : "Avoid bathing within two hours after a meal. Avoid bathing when exhausted by fatigue or from any other cause. Avoid bathing when the body is cooling after perspiration. Avoid bathing altogether in the open air, if, after having been a short time in the water, there is a sense of chilliness, with numbness of the hands and feet, but bathe when the body is warm, provided no time is lost in get- ting into the water. Avoid chilling the body by sitting or standing undressed on the banks or in boats, after having been in the water. Avoid remaining too long in the water, but leave the water immedi- ately if there is the slightest feeling of chilliness. The vigorous and strong may bathe early in the morning on an empty stomach. The young, and those who are weak, had better bathe two or three hours after meals ; the best time for such is from two to three hours after breakfast. Those who are subject to giddiness or faintness, or suffer from palpitation or other sense of discomfort at the heart, should not bathe without first consulting their medical adviser." Clothing. — The object of clothing, apart from the moral and aesthetic aspect, is to aid the skin in its heat-regulating functions. It should, therefore, afford protection against heat and cold, as well as rain and mechanical irritation. Clothing must be adapted to climate and sea- sons, and extremes should be avoided ; as a general rule, warm woolen goods are best suited for winter wear, and cotton or linen for warm weather. It should be understood, however, that flannels absorb more dirt, odors, germs and water than linen or silk, whilst cotton occupies an intermediate position. The question of wet clothing, wheth- er from perspiration or rain, is important, as the drying of clothing on the body involves an expenditure of animal heat, and it is not a matter of indifference whether this takes place rapidly or slowly. It is a fact, that a wet cotton shirt or sweater feels more uncomfortable and colder than a wet woolen garment. The simple reason is that the cotton gar- ment dries more rapidly, but it abstracts during the same time more animal heat than flannels. This fact is not without a practical bearing, as it teaches that persons who perspire easily will do well to wear flan- nels next to the skin, and this is all the more important when they are liable to draughts or abrupt changes in temperature. As a protection against cold, wool is superior to either cotton or linen, and should be worn for all underclothing. In case of extreme cold, besides wool, leather, fur or water-proof clothing, on account of their impermeability to air, are useful. As a protection against cold winds, for equal thickness, leather and india-rubber take the first rank, wool the second. As a protection against rain, india-rubber or oiled canvas clothing is the best, but it is an exceedingly hot dress, owing [00, to its impermeability to air, which causes condensation and retention of the perspiration. To overcome this objection, Duma ' a material, which is water proof and yet permeable, prepared aa follow The garment is placed in a 7 per cent solution of gelatine, heated to a temperature of 100 degrees F. After immersion for a few minuto it dried in the air and after drying it is soaked in a }i per cent solution of alum and again dried. As a protection against heat in the shade, the thickness and conduct- ing power of the material are the only factors to be considered. Text- ure has nothing to do with protection from the direct solar rays ; it depends entirely on color, and white is the best. As a protection against fire, leather clothing is generally worn. The fabric can be rendered non-inflammable by the addition of 20 per cent of tungstate of soda and 3 per cent of phosphate of soda to ordinary starch sizing, while cotton or linen goods may be treated simply with starch and borax, in the proportion of a teaspoon ful of borax to l / 2 pint of starch. Clothing as a Cause of Disease. — Clothing may impair the func- tions of the body and cause disease : 1, By improper fitting, which leads to compression of blood vessels and nerves and interferes with the normal position of organs and the movements of the body ; 2, By im- proper selection of material affording either insufficient protection or overheating a part or the whole of the body ; improper material may also produce irritation or interfere with the ventilation of the skin : 3, By wet clothing, which, in drying, may abstract sufficient animal heat to cause peripheral irritation and reflex internal congestions ; 4, By poisonous dyes, such as compounds of arsenic and antimony, chrome yellow, zinc chloride and some of the aniline colors. The toxic symp- toms may manifest themselves by general- impairment of health or in local affections of the skin ; 5, Clothing may harbor disease germs, and a number of instances are on record in which itch, smallpox, tuberculosis and scarlet fever have been spread by second-hand clothing and bed- ding. This points to the necessity of thorough disinfection. Special Arrangement of Dress. — The head dress. — As long as the head is covered with hair, the head dress should be permeable and not too warm, lest headache may be induced ; on the other hand, insufficient covering may produce neuralgia and rheumatic affections. The head and eyes should always be protected from the direct rays of the sun, and for this purpose broad-brimmed, dark felt hats for cold weather, and straw or some other light-colored material for summer use are the best. For the Neck. — Nothing should be worn around the neck which would overheat the parts, dilate the blood vessels and render the skin no sensitive. The collars should be loose fitting, so as not to compress the blood vessels. The neck ought to be bared as much as possible and hardened by frequent ablutions with cold water. For the Body. — For undergarments, the union suits are the best. They should secure a normal amount of warmth and be so arranged as not to interfere with the free movements of the chest, or compress or displace the abdominal and pelvic organs. For these reasons, cor- sets and waistbands are wholly inadmissible. Suspenders should be worn by both sexes, or women may wear a bodice arranged for the attachment of skirts, so as to suspend their weight from the shoulders. Steel corset stays and tight lacing cannot be too strongly condemned, because there is ample evidence that they have caused displacement and disease of the abdominal and pelvic organs. The stockings should be made of some warm, permeable material, such as wool or merino, as the circulation is rather feeble in the lower extremities, and the feet are more liable to perspire. They should be long enough to reach above the knees and there fastened with some loosely-fitting band. Tight elastic bands and other constricting garters are liable to produce varicose veins. The trousers must be sufficiently loose around the waist and else- where to permit of free circulation of blood. Footzvear. — Boots and shoes are intended to protect the feet from the uneven and rough surfaces of the ground, from cold, wet and even heat, and must be constructed so as to meet these requirements. It is needless to insist that they should be patterned after the foot. The sole of a shoe should be so constructed that the great toe touches it in such a way that a line projected posteriorly through the middle of this toe will strike the middle of the heel. The heel should be broad and low, so as not to throw the weight on the toes. Across the tread and toes, the sole should be sufficiently broad to permit of lateral expansion. The uppers should be soft and flexible, but not too roomy, and should fit snugly around the ankles and insteps. Elastic gaiters are preferable to laced shoes. It is perhaps needless to insist that cleanliness in body and cloth- ing is next to godliness. This may be secured by frequent bathing and change of underwear. It is also a good plan to use night-shirts or pajamas, so as to afford an opportunity for a thorough airing of the underwear worn during the day. If in spite of general cleanliness, there should be indications of excessive sweating and disagreeable odors, especially of the feet, a physician should be consulted. Bed and Bedding. — Since about one-third of our life is spent in bed, something should be said of this article of comfort and necessity. [ [ I As the object of the bed is to promote a refreshing sleep, il should be long and broad enough to permit of the necessary extension of the body; it should he elastic, so as not to compress the soft parts un- necessarily, and it should be warm, but not too warm. Metallic bed" steads are preferable to wood, because less liable to be infected with insects; they should be provided with a woven-wire mattress which admits of free circulation of air. Upon this may be placed a ma' of hair, felt, cotton or excelsior, and pillows preferably made of horse hair. Feather pillows are too heating for the head, unless a layer of paper has been interposed, and high pillows are objectionable, as the position of the sleeper would impede the movement of the diaphragm. Sheets and pillow cases of cotton for winter and of linen for summer are necessary to prevent irritation of the skin and soiling of the mat- tress, pillows and blankets. The most suitable coverings for a bed are woolen blankets ; they are warm and their permeability admits of the escape of gases. For warm weather a cotton quilt or comforter or even a linen sheet are preferable. The bedding should be aired every morning and exposed, whenever practicable, to sunlight, which is Nature's purifier and de- stroys all forms of germs. "Feather beds" and "down quilts" are warmer than blankets, as the air contained in the feathers is a bad conductor of heat, but they are only suitable in very cold climates, or for anaemic and delicate indi- viduals, because they overheat the body, cause dilation of the cutaneous vessels and consequently relax and impair the tone of the skin. The sleeper should lie with his head slightly raised, preferably with the body inclined to the right side. He should rise rather slowly from the recumbent position, since a sudden change to the erect position, not only accelerates the heart's action, but also changes the blood dis- tribution too abruptly. The bed should be so placed that the occupant is not disturbed by the influence of light. A sound, refreshing sleep can only be had when the senses are no longer stimulated, and light is a stimulus which acts even through the closed eyelids. Sleep. — We are still in ignorance of the exact nature of sleep or the suspension of automatic activity of the brain. Some authors main- tain that it is due to an accumulation of waste products in the blood and central nervous system, and that it ceases with the elimination of these products. Others believe that sleep results from the exhaustion of the supply of intra-molecular oxygen, while still others attribute it to a temporary anaemia of the brain. On the whole, there is much reason for assuming that the refreshing effects of sleep are due to the elimination of waste products from the system and the absorption of a fresh store of oxygen. At all events, Pettenkoffer and Yoit found 112 that of the 954.5 grms. of oxygen absorbed by a healthy adult, in the course of 24 hours, 659.7 grms. are absorbed between 6 o'clock in the evening and 6 o'clock in the morning. Amount of Sleep Required. — It is well known that healthy, new- born infants sleep all day, except whilst nursing. About the third or fourth week of their life they may remain awake for one-quarter of an hour, in addition to their nursing; in the seventh or eighth week they remain awake one-half hour, and in the fifth month about one hour, but, even when a year old, a child sleeps more than half of the 24 hours. During the second and third year it sleeps from 10 to 12 hours at night and from 2 to 2^2 hours in the day time. After the completion of the third year, the necessity for sleep in daytime ceases. Uffelmann has made a series of careful observations and believes that "healthy, well-cared-for children between 4 and 6 years of age re- quire 11 hours of sleep; at 7 years of age, 10 to 10^2 hours of sleep; at 10 years of age, g l / 2 to 10 hours of sleep; at 12 years of age, 9 hours of sleep ; at 14 years of age, 83/2 hours of sleep ; youths between 16 and 20, 8^ hours of sleep ; Adults, 7^ to 8 hours of sleep ; while the aged require a larger amount of sleep." No hard-and-fast lines, however, can be drawn ; some children and adults can get along with less, and others require more sleep. On the whole, we may conclude that the average adult requires about 8 hours of sleep, and if the amount is materially lessened languor, pallor, ner- vous irritability and general peevishness may be observed. Excessive sleep is harmful, as it tends to produce sluggishness of the bodily functions, especially of the digestive organs. It lessens tissue metamorphosis and favors the deposition of fat — not to mention the bad effects of the prolonged presence in a polluted atmosphere. We are also beginning to understand that the reason why an excess of sleep instead of being restful to intellectual energy is rather ex- haustive is : after a certain amount of sleep, even though the body continues to be somnolent, the mind awakes and, in the midst of the undirected, rapidly-varying mental excursions which follows as much nerve force and mental energy is expended as would be necessary for the more continuous thinking of regular intellectual work. Irregularity in sleep is always objectionable. The human body resents irregular habits of all kinds. Many infants sicken because of irregular nursing, and we all experience unpleasant symptoms, when from any cause our regular meal hours are interrupted, and it is per- fectly natural that such an important organ as the brain should demand regularity in action and rest. Irregular bed hours are not calculated to promote a sound and re- freshing sleep. Since we enjoy the best sleep before midnight, the "3 hours between 10 o'clock P. M. and 6 A. M. or n to 7 A. M. are the most suitable. Opinions differ as to the admissibility of a nap after dinner, and the question must be decided by individual circumstances. It is quite certain, however, that there is no physiological necessity for such a sleep in healthy children above the age of four, nor for men and women in their best years, unless they have taken an inordinate amount of food. Persons in advanced age may profit by a short rest, which seems often demanded by an overwhelming drowsiness ; the same may be said of delicate and anaemic individuals and those suffering from diseases of the digestive system. Dreams. — In spite of considerable research the occult character of dreams has not been entirely cleared up, although psychologists are agreed that they constitute a manifestation of intellectual life in- volving the expenditure of a certain amount of brain force or mental energy. Practical experience also teaches that a dreamless sleep is in every way recuperative, while a dreamful night produces a tired feeling in the morning; hence dreams should be avoided, if possible. There is much reason for believing that the old custom of relating dreams, and the attempt to interpret them, has a bad effect on the minds of all, and especially of children, as it tends to bring about a similar mental rambling during sleep of subsequent nights. Attention has recently been called in an editorial (Journal A. M. A., July 28, 1907), to the fact that children suffer more frequently from night terrors, which are really overvivid dreams, on Sunday and Monday nights. This is partly attributed to the fact that the children have indulged in the "imagination-intoxicating" colored supplement to the Sunday newspaper with its horrors and its dream suggestions. Those of us who have been brought up in rural districts and have listened to dream tales and folk-lore and perused exciting literature have learned that all of this is productive of dreams and night terrors, and should be avoided. CARE OF SPECIAL ORGANS OR PARTS OF THE BODY. Importance of Good Teeth. — When we recall the physiology of digestion it is scarcely necessary to point out the importance of a good set of teeth in order to secure thorough mastication and insalivation of the food. The temperature of food and drink exerts a special in- fluence on our teeth. It has been shown that a sudden change from hot to cold in the mouth causes the enamel to crack, and leads to premature decay of the teeth, because the microbes in the mouth will find these fissures a suitable lurking place for their destructive work. 114 The temperature of food should as nearly as possible approach the normal animal temperature 98.2 degrees, and a temperature of 46 de- grees may be regarded as an extreme low temperature and one of 120 degrees as an extreme high temperature for the introduction of food or drinks. 1 The teeth should never be used for the purpose of crack- ing nuts. Microbes of every description abound in the mouth, and find in the presence of lodged and decaying particles of food a suitable medium for their multiplication. In order to prevent their destructive effects, cleanliness of the mouth is absolutely essential. This can be secured by brushing the teeth with water and castile soap after each meal and before retiring. In case particles of food cannot be thus dislodged, a soft silk thread drawn between the teeth will accomplish the purpose more effectively and wisely than a tooth pick. If the teeth are already painful, or show evidence of decay or of accumulation of tartar, a dentist should be consulted. It is a wise plan to have the teeth examined once a year, and as there are free dental infirmaries, the question of cost should not deter even the least resourceful people. Habit and Regularity of the Bowels. — As pointed out by Hammond 2 when we perform an act under the operation of certain impressions, there is a tendency towards the performance of a similar act, if like influences are brought to bear upon the organism. "This disposition to repetition prevails in nearly every function of the body and mind until some powerful force intervenes." It is shown by the sensation of hunger and thirst which occur at customary meal hours, the desire to evacuate the bowels at the same hour of the day, the desire for sleep, the hour of awakening and the inexpressible feeling excited by the want of a smoke or a customary stimulant. Constipation. — When regularity of the bowels is established, the desire to go to the stool returns at the same hour. If this tendency is resisted, it is not long before constipation becomes the rule, with all its attending consequences of ill health. The most natural remedy to correct this morbid habit will be persistent effort to secure an evacua- tion every day at a fixed hour, aided by the use of succulent vegetables and fruits, and if necessary by small doses of olive oil, cotton-seed oil or Epsom salts and water. One of the most baneful effects of constipation is hypochondry — a nervous and mental condition brought about by absorption of poison- ous products in the intestinal tract, and the continued action of the mind upon some one organ or function supposed to be disordered, nota- x It is believed that this question also plays an important role in the undue prevalence of dyspepsia. 2 Treatise on Hygiene, Wm. A. Hammond, 1863, p. 122. "5 bly the heart, liver and stomach. The disease appears most commonly in irritable individuals and in those exhausted from a variety of causes. Such persons are of sound judgment in other respects, but reason erroneously on whatever concerns their own health. In these cases, apart from correcting the digestive derangements, it is often necessary to act upon the mind by keeping it occupied with matters which will divert the thoughts of the patient from himself. This is often readily accomplished on the golf links in persons who require exercise. Care of the Eyes. — It is well known that exposure of the eyes to the direct rays of the sun may cause inflammation of the retina and even total blindness, and similar effects may be produced by the reflected rays of the sun from mirrors, sheets of water, white walls and snow (snow blindness). On the other hand, defective lighting, as pointed out on page 80, also produces mischief, and must, therefore, be avoided in the home as well as in the shop. Sudden transposition from light to dark, or dark to light, is also injurious and may cause serious diseases of the eyes. Whenever there is any evidence of redness, inflammation, pain, watering or "mattering" of the eyes, a physician should be con- sulted. While free bathing of the eyes with cold water may exert a preventive and tonic effect, the value of good eysight is too great to trust to domestic remedies, or even to the services of an optician. Whenever there is any difficulty in reading, accompanied by pain or headache, an occulist should be chosen. When we recall the number of accidents which befall the eyes in many occupations, the importance of protective goggles must be apparent. Ear and Nose. — These organs should be kept clean. There is danger from lodgment of foreign bodies, particularly in children, which may impair the hearing for life, especially when injudicious attempts at removal have been made. In such instances it is always best to consult a competent physician. The chief function of the nose evi- dently is to arrest more or less of the dust and germs upon its mucous surfaces, and in cold weather to warm the inspired air. Hence, the importance of cleanliness and of breathing through the nose instead of the mouth. In order to do this without discomfort, it is necessary that there be no obstruction in the nasal passages, and persons suffer- ing from ca'.arrh or other symptoms of difficult breathing will do well to undergo treatment. In this connection attention should be called to the advantages of so-called ''deep breathing" in the open air or near an open window. This is best accomplished by taking 10 or 12 deep inspirations morning and evening, so as to inflate the lungs to their fullest expansive capacity. This practice is believed to secure a thor- ough ventilation of all the air vesicles and to increase the power of resistance to the invasion of the tubercle bacillus. n6 APPENDIX A.. HEALTH OF EMPLOYEES IN THE GOVERNMENT PRINT- ING office, Washington! 1 By Wji. J. Manning, M. D., Chief of the Sanitary Division, Govern- ment Printing Office. Owing to improved hygienic conditions in modern printing offices, type foundries and stereotype and electrotype foundries, lead poison- ing now exists to a very limited extent in these trades. In the Government Printing Office at Washington, where upward of 4,500 employees are gathered in one building, excellent hygienic conditions prevail. Every ten minutes the air in each nxm is changed by a very simple device, consisting of air shafts leading from the basement to the roof and which are pierced in such room near the ceiling with suitable openings. A revolving fan placed just below the roof creates a suction, so that a constant supply of fresh air is available at all times, owing to the vacuum thus formed. The electrotype and stereotype foundries are placed on the topmost floor, the modern, rapidly moving elevators making this practicable, so far as the employees are concerned. At that height from the ground currents of air are constantly in motion, with a consequently greater diffusion of the gases than would prevail on floors nearer the ground. In the large newspaper buildings of the various cities in the United States the same idea is being carried out, these rooms being placed as high in the air as possible. In the type-founding and stereotyping trades employees whose duties call them to work over the fumes of the melting pots are most exposed to the injurious influences of lead, although the large amount of alloy present tends to lessen the danger. "Finishers" of the plates, who handle only the smooth, hard, bright slabs of the alloyed metal, which are free from all oxides, run the least risk of lead poisoning. The fact that there is little or no dust, coupled with the fact that the small particles which rub off the plates on the 'Dr. Manning's article on Plumbism, which is here reproduced, was sub- mitted by him in competition for a prize offered by the Internationales Arbeitsamt, Basel, Switzerland. The article was purchased for publication by that office on account of merit. I./ hands of the workman are in the metallic state and perfectly dry, renders it less liable tO be absorbed. Ill eonlradi .tin- Hon tO tin i the case of the painter. Mere tin- lead, being in the form <>\ a carbonate (white lead) and being mixed witli SUCH an excellent ab orbing mate- rial as oil, is much more rapidly absorbed. In type foundries practically the ame condition exii t a- in electro- type foundries. Those who work in the vicinity of the melting pots are much more liable to the toxic vapors which arise from the melting pot. This is particularly the case where the lead is impure and con- tains volatile substances which, combining with the lead fumes, might possibly add to the toxic influences of the lead. Hence, in "fluxing" the metal, when wax is used as the agent, as little as possible should be used. Females are, as a rule, employed in this country to sort, finish, and pack the type. Here, as with the "finishers" in the electrotype foundries, the metal is bright and free from oxides, besides being largely alloyed ; hence, the chance of absorption with toxic results is greatly lessened. Doctor Osier has pointed out that the ratio of women susceptible to lead poisoning is small as compared with men. Why they are thus immune is hard to say ; but, so far as type founding is concerned, probably the above statement indicates the cause. With the compositor the chances of absorption of lead from the type metal by the skin is probably nil. Only a small portion of the epidermis of the fingers (the apex of the thumb and forefinger) is brought in contact with the metal both in "distributing" and in "setting," and the epidermis at these parts is in a more or less thickened, dense condition. Thus, the compositor is protected from absorbing the metal, even when the type is covered with the hydrate which is formed by the long-continued action of air and water. It is well known that sub- stances are absorbed but slightly, if at all, through the skin that is in a thickened condition. If one will stop to consider that the small atoms which become separated from the metal type in one way and another are in a metallic form the chances of absorption are even more remote. The danger to the compositor, as with the melting-pot tender, would seem to lie in inhalation. With the former the introduction into the system would be by dust, and with the latter in the form of gas. When foreign bodies are taken into the system in a state of fine sub- division, the favorite seat will be found, as a rule, in the bronchi and the lungs. The process, so far as compositors are concerned, might be termed plumbiosis. The dust which is not carried directly into the alveoli of the lungs by the air breathed finds lodgment on the mem- brane of the bronchi and the ramifications thereof. That considerable n8 is carried down the esophagus into the stomach and from there swept out into the intestines is not to be doubted. Might not these fine par- ticles cause the "colic" or active peristalsis by the stimulation of the circular and longitudinal muscular fibers in a mechanical way on the muscles themselves or in a chemic way by a stimulation of the nerves controlling these fibers? This "colic" is one of the first symptoms complained of by the patient. That the white blood corpuscles play an important part in carrying this finely divided substance throughout the body is also probable, the mode of action being to inclose the fine particles and try to dissolve them, and, failing in that, to transport them to distant points in the body and to the various organs. In that condition known as anthra- cosis, or coal-miner's consumption, the lung is found to be covered with black dust. The same conditions are found in those suffering from stonecutter's consumption, the lack of carbon rendering the pig- ment somewhat lighter in color. The condition is known as lithosis. In the knife and saw sharpener's trade the dust is in the form of steel and the consequent disease is known as siderosis. In each case the fine dust finds lodgment in the lungs. The lungs become so pigmented after long exposure to these condi- tions, and the alveoli so congested and choked, accompanied by a low form of inflammation that the substances set up, that this, with the unhygienic surroundings and bad ventilation, might explain why so many compositors die each year from tuberculosis. Certainly the tubercle bacilli find a congenial environment in which to begin their fatal work. To the above conditions must be added, of course, the toxic influence of the lead itself, together with the persistent astringent effect of the lead on the air cells. Lead is a very feeble antiseptic and does not seem to inhibit the growth of the bacilli. The lymph nodes very likely play an important part in carrying the lead through the body to produce plumbism. When lymph nodes become loaded with foreign material of any nature they are apt to break down and the circulation carries the substances to various parts of the body. This would seem to explain the peculiar color of those suffering from plumbism, and it might explain why the kidneys become so irritated and why albumin is found in the urine. Certain tissues seem to have an affinity for the lead thus carried and it is deposited in them. The blue line on the gums which is pathognomic of lead poison- ing may be the result of this. It may be that sulphur, which has such a strong affinity for lead and which might be taken into the mouth in arti- cles of food and drink causes this pigmentation. It is strange that the blue line does not make its appearance on any other part of the body. «9 Certain it is that potassium sulphide when added to a bath will bring out this pigment over the entire body, whirl) remains until the lead in the skin is either eliminated or the affinity is satisfied. Lead poisoning in. the chronic form, as already stated, is very rare among type founders, electrotypcrs, stereotypcrs and in the printing trades in this country. It may present itself in the regular type or the symptoms may be hidden. The characteristic symptoms are the blue line on the gums, and the wrist drop, due to the paralysis of the exten- sors of the forearms. In some cases it first makes its appearance in anaemia and in loss of strength. Anaesthesia may appear in spot on different parts of the body, the spots varying in size from half a dollar to tracts as large as the hand. They may appear on the arms, legs, or on the back. In some cases, however, these symptoms are entirely absent. Albumin may appear in the urine. Doctor Osier describes cases that have come under his care where the symptoms resembled gout and rheumatism. The joints would swell and become very red and tender, the patient suffering all the while intense pain. Doctor Wood mentions cases where the symptoms resembled acute poliomyelitis. In other cases there was simply a failure of health, anaemia, nervous phenomena, etc., the patient having ill-defined, sharp, shooting pains. The pain from the colic seems to merge from the umbilicus in all in- stances. Arteriosclerosis has been noticed with atrophy of the kidneys and hypertrophy of the heart, the enlargement of the latter organ probably being due to the redoubled effort of the heart to force the blood through the various contracted distal organs. This contrac- tion may be due in a measure to the astringent action of the lead which is noticed upon all tissues when lead is applied in its various forms. The treatment in these cases may be divided into the preventive and curative, the former relating, of course, only to the trades men- tioned in this article. Among the measures which might be taken in the prevention of plumbism in the printing, type founding, and electro- typing and stereotyping trades would be, first of all, the location. The rooms devoted to the melting of type metal should be situated as high as possible in the air and on the topmost floor of the building. The pots should be covered with iron hoods that will cover the entire top of the melting pot proper. The hood should set as near the metal as possible, in such a way that it will not interfere with the manipula- tion of the ladles or dippers. Hoods with small pipes when used as fume chambers do not answer. It has been found that to be of any service or benefit, the pipe leading from the hood or fume chamber should be nearly as large as the chamber itself and should lead to a smoke chimney or into the outside air. The heat generated should 120 supply draft enough to carry the fumes off in this way. It might be aided by placing a revolving, circular ventilator in the pipe from the outside and operated by the wind. The whole thing might be made very cheaply of galvanized iron. Various face masks have been sug- gested, but none seem to be practical, and after they are worn for some time really become a greater danger than if they had not been used, owing to the lack of cleanliness. Cotton and such substances in the nose are useless, because the workman will then breathe through his mouth. The rooms should be at least 10 feet high. Windows should be placed on both sides of the room, so that a current of air may be in constant motion and a fresh supply always on hand. In winter or bad weather a very simple way to obtain fresh air consists in placing a board 3 or 4 inches high lengthwise under the lower window sash. This will enable the fresh air to enter between the lower and upper windows without causing a direct draft on the workmen. The personal treatment on the part of the workman should be a change of underclothing after work, a bath at least three times a week in hot water with plenty of soap, and at the same time the vig- orous application of a flesh brush to the skin. The object here is twofold — to keep the pores free and to remove any particles that may have lodged there, and hence lessen the danger of absorption, while at the same time helping the pores to eliminate that which has been absorbed. The bowels should be kept open by the use of such simple laxatives as sweet oil, castor oil, calomel and soda, etc. An electro- typer who has been in the business for some forty years, and who is now the chief of the largest foundry in the world, informed me that it was his custom to take a teaspoonful of sweet oil every other day and that he had never suffered from any ill -effects of plumbism. So far as compositors are concerned the preventive treatment just described would apply to them. The principal danger here is the bad ventilation, insanitary surroundings, and the dust (principally graphite and minute particles of type metal) which becomes detached by the abrasion of the pieces against each other while being handled. To off- set this, "cases" should be blown out by a bellows at least once each week ; if possible, in the open air. The bottoms in the different boxes, instead of being flat and square cornered and covered with paper, should be slightly concave at the bottom, with the corners rounded somewhat like a cash till, the idea being to keep the dust from lodging in the corners, where it is difficult to remove even with a bellows. In cases constructed in this manner the dust is, by its own weight, constantly working its way toward the center of each box, where it can easily be removed. 121 A practical method of removing the caked dual i in vogue in the Government Printing Office al Washington. The type forms after leaving the electrotype foundry are placed on a raised rack which drains into a shallow tank sonic 6 inches in depth, a pipe connecting this with a sewer. The forms arc placed in a horizontal po ition — that is to say, the side of the chase rests on the rack. Steam under pn is conducted by a rubber hose and the face of the type ' thoroughly "blown," as is the reverse of the form. Later, when the form-, are unlocked, the pages are tied up and placed in the "boiling chamber." This chamber consists of a zincdined box about 6 feet in length, 4 feet wide, and 4 feet high, a trapdoor opening from the top being the only opening. In the bottom is placed a coil of steam pipe which covers the entire floor of the box, one end of the pipe being left open. The pages of type are placed on shallow perforated trays somewhat like a "galley," each tray fitting in a copper rack, consisting simply of two loops of copper, somewhat like an inverted U with pins attached on which the trays set. Each rack holds eight pages, or a "signature," on the eight trays. After the box is filled, steam is turned on and the type is thoroughly boiled for an hour or more. The cages are lifted in and out by means of hooks. This method not only removes the graphite, but disintegrates the type and "loosens" it, permitting easy distribution. It also leaves the type very clean and aseptic, lessen- ing the chances of infection by the absence of germs. The method of letting cold water run on the forms and thus cleansing them is not so thorough, because the graphite "cakes" and clings to the type and the dust is thrown into the compositor's case with the type, making the cases very dusty and dirty. Each compositor should supply himself with a small brush, suitable for the hands, to be used each time he washes. A private drinking cup is desirable. In acute cases of lead poisoning the treatment consists in the admin- istration of alkaline carbonates, soap, soluble sulphates, sodium chloride, etc., washing out the stomach with large drafts of water, etc. Alum has been given, and at one time was considered almost a specific. Sweet oil and castor oil will be found useful. Milk should be taken in large quantities. The idea is first to combat the symptoms and then eliminate the lead. Opium can be given for pain. Warm sulphureted baths are very beneficial. They can be made by dissolving 4 ounces of potassium sulphide in 30 gallons of water in a wooden tub. These baths discolor the skin, from the formation of lead sulphide, and should be repeated every few days until this effect ceases. During each bath the patient should be well washed with soap and water to remove discoloration. 122 The various kinds of typesetting machines all have a melting pot attached to each machine, and where many are in use, unless there is plenty of pure air constantly entering the room and perfect ventila- tion provided, the fumes from each pot should be conducted by pipes to a chamber in which a vacuum is present, so that the fumes may be instantly removed and carried out into the atmosphere. The virtue of the machine lies in the fact, so far as health is concerned, in the absence of dust, and with the additional advantage on the part of the operator that he does not lay himself open to exposure in handling the metal to so great a degree as in the case of the hand compositor. There are other alloys that would take the place of lead in type metal, but owing to the excessive cost and high fusing point their use is not practical. Dr. Manning's Method for the Collection, Cleaning and Disinfection of Spittoons. — From a sanitary point of view the collection, cleaning, and disinfection of the spittoons in the Government Printing Office is a matter of considerable importance. This will be readily understood when it is remembered that there are over 4,500 persons engaged during the 24 hours, all working in eight-hour shifts, and that no fewer than 1,200 cuspidors must be cleaned at the end of each shift. The method now being installed under Dr. Manning's direction effects this without direct digital contact. It consists in a central sterilizing chamber situated in the basement of the Printing Office, with a cement floor, graded toward the center and made up of two inclines and six shallow gutters, i. e., concavities or semilunar grooves in the cement floor under each iron longitudinal rack extending lengthwise of the room, there being six of such frames or racks, which consist of simply i-inch angle-iron strips f^-inch in thickness, arranged in tiers, 13 inches apart, from which hang suspended at intervals of 9 inches steel-wire spring clutches, secured by a nut and bolt through the eye of clutch and bolted firmly to the underside of angle iron. All edges, angles, corners, and returns of the floor are to be well rounded and the base of each of the four walls are to have 12-inch "sanitary bases" in order that all parts of the room may be self cleansing and draining. The walls of the sterilizing chamber are composed of white, glazed, vitrified brick. The wire clutch is shaped somewhat liked an inverted letter U, and grasps the cuspidor around the constricted portion or neck when the latter is pressed against the orifice or bell-shaped opening at the bot- tom of the spring. This spring permits both expansion and contrac- tion around the neck of the cuspidor, and has a sufficient grasp to hold the latter firmly in place while it is subjected to internal and 123 external washing with a stream of hot water from a hose. After thorough cleansing, the cuspidors are subjected to the action of super- heated steam, hy which all forms of vegetable and organic li: killed, even the most resistant spore-bearing disease germs. The cuspidors are collected in the workrooms by a mechanical device or holder so designed as to clutch and "nest" at one time five of the soiled cuspidors, one above the other, and are carried directly, by means of the holder, to specially designed wooden, zinc-lined box trucks with detachable sides. Each truck is capable of holding 175 cuspidors for transmission to the sterilizing chamber. As five soiled cuspidors are taken to the truck they are replaced by five sterilized cuspidors picked up and distributed by the same mechanism, all of which is accomplished by the use of one hand only of the operator. After the trucks are filled they are transmitted from the respective floors to the basement on a freight elevator and wheeled directly into the sterilizing chamber. Here one of the sides of the box truck is removed, and the operator, by the use of another specially designed forcep, reaches out and grasps the lip of a cuspidor, lifts it free, and with a pronation or twist of the wrist empties the vessel. At the same time, with an upward movement, still grasping the forceps, the con- stricted part of the cuspidor is brought against the bottom of the wire clutch, which receives and holds it in the manner already described. When the racks have been thus filled, the operator faces the front of the racks or mouths of the cuspidors and directs a stream of boiling hot water into and against the cuspidors. The same method is pur- sued from the rear of each respective rack, and thus a large number of cuspidors are quickly cleaned in a thorough and absolutely sanitary manner. As soon as this operation has been completed, the floor is thoroughly flushed with hot water and all foreign matter is carried by means of two centrally located waste outlets protected by a back-pressure valve into the sewer. The door of the sterilizing chamber is built on the order of a bulk- head door of a steamer and is closed with a swivel "keeper"' and is steam tight. For economic reasons an exhaust steam pipe is tapped and a branch carried into the top of the sterilizing chamber. This pipe has a number of apertures on the underside and quickly fills the room with steam, coming from above downward. The sterilization is continued for one hour at a temperature of about 100 degrees centigrade. At the expiration of this period the steam is turned off and the air shaft leading to roof opened for the escape of steam and to aid condensation, thus quickly ridding the room 124 of all vapor. The door of chamber is then opened, and the operator, after the cuspidors have cooled, plucks them from the rack with his hands and proceeds to place layer after layer in trucks until the latter are full. When a layer is laid in a truck, he pours in a solution made of bichloride of mercury, J.% grains ; citric acid, J.J grains, to each liter of water, colored with fuchsine to differentiate the solution. This gives a strength, approximately, of 1 :2000, sufficient to destroy whatever infectious germs may find their way into the cuspidors through expec- toration or otherwise. The bichloride is used for its germicidal power, while the citric acid is added to retard the coagulation of the albumin in the saliva and ex- pectoration and thus render the action of the bichloride of mercury more potent. The entire cost of the chemical disinfectants named amounts to less than $12 per annum. The cuspidors are specially designed to permit of easy cleaning and self-draining largely on account of the character of the curves em- ployed. Angles which would interfere with the cleaning process have been avoided, and the stream of water will readily reach all the inter- nal surfaces. The constriction or neck is sufficiently wide to permit the stream of the hose to enter with full force. A certain amount of con- striction at the neck seemed desirable to hide the contents of cuspidor when in use. They were designed, however, with the special object of easy cleaning and without direct digital contact, because it would seem almost inhuman to ask a cleaner to place his hand, containing even a sponge, in the ordinary stock cuspidor and wash the interior in a thorough and sanitary manner. All of this repulsive work has been avoided, so that by the new method the operator does not touch the cuspidor with his hands until he plucks the washed and sterilized cus- pidor from the rack and places it in the truck. Hard vitrified china ware has been used to construct the cuspidors, as this is the only material that will withstand the corrosive action of bichloride of mercury and at the same time present a smooth surface for sanitary cleansing. Approximately about 3,800 barrels of sawdust are used each year for cuspidors in the Government Printing Office, at a cost of about $100 per month. While, of course, this item will be saved, together with the cost of handling and carting away of the foul and polluted sawdust, the main object has been to reduce to a minimum the danger of infection through tuberculosis sputa among the employees. 1 J A11 of the mechanical devices used in the above method have been designed by Dr. Manning. 125 The report of Dr. Manning, in charge of tin- Sanitary Division oi the Government Printing ( )fliee, shows that of 4,556 employees in the building from January 1st, 1906, to February 29th, 1908, ',153 em- ployees received treatment at the Emergency Room, 595 were medical cases inclusive of 9 cases of lead-colic. Of these 516 resumed work, j6 were sent home for treatment and 3 died. Of the 558 sir cases, 517 resumed work and 41 were sent home for treatment. The Emergency Department is well equipped and the results have in every way justified its establishment. APPENDIX— REGULATION OF DANGEROUS TRADES [N ENGLAND. (In addition to the general provisions regarding ventilation, etc., which apply to all manufacturing establishments, the English Factory and Workshop Act (1901) contains a chapter of Special Provisions for dangerous and unhealthy industries, which is reprinted below, together with the Special Rules and Regu- lations issued by the government officials in accordance with the grant of author- ity therein made.) FACTORY AND WORKSHOP ACT, 1901. Part IV. — Dangerous and Unhealthy Industries. (0 Special provisions. Section 73. (1) Every medical practitioner attending on or called in to visit a patient whom he believes to be suffering from lead, phosphorus, arsenical or mercurial poisoning, or anthrax, contracted in any factory or workshop, shall (unless the notice required by this subsection has been previously sent) send to the chief inspector of factories at the home office, London, a notice stating the name and full postal address of the patient and the disease from which, in the opinion of the medical practitioner, the patient is suffering, and shall be entitled in respect of every notice sent in pursuance of this section to a fee of two shillings and sixpence, to be paid as part of the expenses incurred by the secre- tary of state in the execution of this act. (2) If any medical practitioner, when required by this section to send a notice, fails forthwith to send the same, he shall be liable to a fine not exceeding forty shillings. , (3) Written notice of every case of lead, phosphorus, arsenical or mercurial poisoning, or anthrax, occurring in a factory or workshop, shall forthwith be sent to the inspector and to the certifying surgeon for the district; and the pro- visions of this act with respect to accidents shall apply to any such case in like manner as to any such accident as is mentioned in those provisions. (4) The secretary of state may, by special order, apply the provisions of thii section to any other disease occurring in a factory or workshop, and thereupon this section and the provisions referred to therein shall apply accordingly. Sec. 74. If in a factory or workshop where grinding, glazing, or polishing on a wheel, or any process is carried on by which dust, or any gas. vapor, or other impurity, is generated and inhaled by the workers to an injurious extent, it appears to an inspector that such inhalation could be to a great extent prevented by the use of a fan or other mechanical means, the inspector may direct that a fan or other mechanical means of a proper construction for preventing such inhalation be provided within a reasonable time, and if the same is not pro- vided, maintained and used, the factory or workshop shall be deemed not to be kept in conformity with this act. 126 Sec. 75. (1) In every factory or workshop where lead, arsenic or any other poisonous substance is used, suitable washing conveniences must be provided for the use of the persons employed in any department where such substances are used. (2) In any factory or workshop where lead, arsenic, or other poisonous sub- stance is so used as to give rise to dust or fumes, a person shall not be allowed to take a meal or to remain during the times allowed to him for meals, in any room in which any such substance is used, and suitable provision shall be made for enabling the persons employed in such rooms to take their meals elsewhere in the factory or workshop. (3) A factory or workshop in which there is a contravention of this section shall be deemed not to be kept in conformity with this act. Sec. 76. (1) A woman, young person or child must not be employed in any part of a factory in which wet-spinning is carried on, unless sufficient means are employed and continued for protecting the workers from being wetted, and where hot water is used for preventing the escape of steam into the room occu- pied by the workers. (2) A factory in which there is a contravention of this section shall be deemed not to be kept in conformity with this act. Sec. 77. (1) In the part of a factory or workshop in which there is carried on — (a) the process of silvering of mirrors by the mercurial process; or (b) the process of making white lead, a young person or child must not be employed. , (2) In the part of a factory in which the process of melting or annealing glass is carried on a female, young person, or a child must not be employed. (3) In a factory or workshop in which there is carried on — (a) the making or finishing of bricks or tiles not being ornamental tiles; or (&) the making or finishing of salt, a girl under the age of sixteen years must not be employed. (4) In the part of a factory or workshop in which there is carried on — (a) any dry grinding in the metal trade; or (b) the dipping of lucifer matches, a child must not be employed. (5) Notice of a prohibition contained in this section must be affixed in the factory or workshop to which it applies. Sec. 78. (1) A woman, young person or child must not be allowed to take a meal, or to remain during the time allowed for meals in the following factories or workshops, or parts of factories or workshops ; that is to say, — (a) in the case of glass works, in any part in which the materials are mixed; and (6) in the case of glass works where flint glass is made, in any part in which the work of grinding, cutting, or polishing is carried on; and, (c) in the case of lucifer-match works, in any part in which any manufactur- ing process or handicraft (except that of cutting the wood) is usually carried on; and (d) in the case of earthenware works, in any part known or used as dippers house, dippers drying room, or china scouring room. (2) If a woman, young person, or child is allowed to take a meal or to remain during the time allowed for meals in a factory or workshop or part thereof in contravention of this section, the woman, young person, or child shall be deemed to be employed contrary to the provisions of this act. (3) Notice of the prohibition of this section shall be affixed in every factory or workshop to which it applies. (4) Where it appears ( x ) to the secretary of state that by reason of the nature of the process in any class of factories or workshops or parts thereof not named in this section the taking of meals therein is specially injurious to health, he may, if he thinks fit, by special order, extend the prohibition in this section to the class of factories or workshops or parts thereof. (5) If the prohibition in this section is proved to the satisfaction of the sec- retary of state to be no longer necessary for the protection of the health of women, young persons, and children, in any class of factories or workshops or parts thereof to which it has been so extended, he may, by special order, rescind the order of extension, without prejudice to the subsequent making of another order. J For orders extending the prohibition in this section, see post. 127 (u) Regulations for dangerous trades. Sec. 79. Where the secretary of state is satisfied thai any manufacture, ma- chinery, plant, process, or description of manual labor, u < the workmen as compensation since the date oi thi certificate shall be deducted from the Bums payable to the dependants. (b) The paymenl .hall, in case of death, be made to the legal pi i onal repre- sentative "I the workingman, or, if lie has no legal pcr'.onal r- pr< > ntativc, to or for the benefil oi his dependants, or, if he leaves no dependants, u > the ; to whom the expenses arc due; and if made to tin l-.i'.al |«t onal r- preventative shall be paid hy him to or for the benefit of the dependants or other p entitled thereto. (c) Any question as to who is a dependant, or as to the amount payable to each dependant, shall in default of agreement be settled by arbitration as herein- after provided in clause 9. (d) The sum allotted as compensation to a dependant may be invested or otherwise applied for the benefit of the person entitled thereto, as agreed, or as ordered by the arbitrator. (e) Any sum which is agreed or is ordered by the arbitrator to be invested may be invested in whole or in part in the post-office savings bank. 3. Where a workman has been suspended and certified as provided in Condi- tion I, and while he is totally or partially prevented from earning a living by reason of such suspension, he shall be entitled to a weekly payment not ex- ceeding fifty per cent of his average weekly earnings at the time of such sus- pension, such payment not to exceed £1 [$4X7]. The average may be taken over such period, not exceeding twelve months, as appears fair or reasonable having regard to all the circumstances of the case. 4. In fixing these weekly payments, regard shall be had to the difference between the amount of the average weekly earnings of the workman at the time of his suspension and the average amount, if any, which it is estimated that he will be able to earn afterwards in any occupation or employment, and to any payments (not being wages) which he may have received from the employer in respect of the suspension, and to all the circumstances of the case, including his age and expectation of life. 5. If it shall appear that any workman has persistently disobeyed the special rules or the directions given for his protection by his employers, and that such disobedience has conduced to his suspension, or has not presented himself for examination by the certifying surgeon, or has failed to give full information and assistance as provided in Condition 6, his conduct may be taken into con- sideration in assessing the amount of the weekly payments. 6. It shall be the duty of every workman at all times to submit to medical examination when required and to give full information to the certifying sur- geon and to assist to the best of his power in the obtaining of all facts necessary to enable his physical condition to be ascertained. 7. Any weekly payment may be reviewed at the request either of the em- ployer or of the workman, and on such review may be ended, diminished, or in- creased, subject to the maximum above provided, and the amount of payment shall, in default of agreement, be settled by arbitration. 8. Any workman receiving weekly payments under this scheme shall submit himself if required for examination by a duly qualified medical practitioner pro- vided and paid by the employer. If the workman refuses to submit himself to such examination or in any way obstructs the same, his right to such weekly payments shall be suspended until such examination has taken place. 9. If any dispute shall arise as to any certificate of the certifying surgeon or as to the amount of compensation payable as herein provided, or otherwise in relation to these provisions, the same shall be decided by an arbitrator to be appointed by the employer and workman, or in default of agreement by the secretary of state. The said arbitrator shall have all the powers of an arbitra- tor under the Arbitration Act, and his decision shall be final. The fee of the arbitrator shall be fixed by the secretary of state, and shall be paid as the arbitrator shall direct. 10. No compensation shall be payable under these provisions unless notice of claim in writing is made within six weeks of the date of the certificate of suspension, or of the death, provided that the want of such notice shall not bar the claim if in the opinion of the arbitrator there was reasonable excuse for the want of it. 140 A claim for compensation by any workman whose employment is intermittent, or casual, or who is regularly employed by more than one employer, shall only arise against the employers for whom he has worked in a process included in Schedule A within one month prior to his suspension. The said employers shall bear the compensation among them in such proportion as in default of agree- ment shall be determined by an arbitrator as herein provided. II. "Employer" includes an occupier, a corporation, and the legal representa- tives of a deceased employer. "Workman" includes every person, male or female, whether his agreement be one of service or apprenticeship or other- wise, and is expressed or implied, orally, or in writing, and shall include the personal representatives of a deceased workman. "Dependants" has the same meaning as in the Workmen's Compensation Act, 1897. The terms contained in this notice shall be deemed to be part of the contract of employment of all workmen in the above-named process. Electric Accumulators. Whereas the manufacture of electric accumulators has been certified in pur- suance of section 79 of the Factory and Workshop Act, 1901, to be dangerous ; I hereby, in pursuance of the powers conferred on me by that act, make the following regulations, and direct that they shall apply to all factories and work- shops or parts thereof in which electric accumulators are manufactured. In these regulations "lead process" means pasting, casting, lead burning, or any work involving contact with dry compounds of lead. Any approval given by the chief inspector of factories in pursuance of these regulations shall be given in writing, and may at any time be revoked by notice in writing signed by him. Duties of occupier. 1. Every room in which casting, pasting or lead burning is carried on shall contain at least 500 cubic feet of air space for each person employed therein, and in computing this air space, no height above 14 feet shall be taken into account. These rooms and that in which the plates are formed, shall be capable of thorough ventilation. They shall be provided with windows made to open. 2. Each of the following processes shall be carried on in such manner and under such conditions as to secure effectual separation from one another and from any other process : — (a) Manipulation of dry compounds of lead; (b) Pasting; (c) Formation, and lead burning necessarily carried on therewith; (d) Melting down of old plates. Provided that manipulation of dry compounds of lead carried on as in Regula- tion 5 (b) need not be separated from pasting. 3. The floors of the rooms in which manipulation of dry compounds of lead or pasting is carried on shall be of cement or similar impervious material, and shall be kept constantly moist while work is being done. The floors of these rooms shall be washed with a hose pipe daily. 4. Every melting pot shall be covered with a hood and shaft so arranged as to remove the fumes and hot air from the workrooms. Lead ashes and old plates shall be kept in receptacles specially provided for the purpose. 5. Manipulation of dry compounds of lead in the mixing of the paste or other processes, shall not be done except (a) in any apparatus so closed, or so arranged with an exhaust draft, as to prevent the escape of dust into the workroom; or, (&) at a bench provided with (1) efficient exhaust draft and air guide so ar- ranged as to draw the dust away from the worker, and (2) a grating on which each receptacle of the compound of lead in use at the time shall stand. 6. The benches at which pasting is done shall be covered with sheet lead or other impervious material, and shall have raised edges. 7. No woman, young person, or child shall be employed in the manipulation of dry compounds of lead or in pasting. 8. (a) A duly qualified medical practitioner (in these regulations referred to as the "appointed surgeon") who may be the certifying surgeon, shall be ap- 141 pointed by the occupier, BUCfa appointment unless held by the certifying surgeon to be subject to the approval of the chief inspector of factories. (b) Every person employed in a lead process shall be examined once a month by the appointed surgeon, who shall have power to suspend from employment in any lead process. (c) No person after such suspension shall be employed in a lead process without written sanction entered in the health register by the appointed surgeon. It shall be sufficient compliance with this regulation for a written certificate to be given by the appointed surgeon and attached to the health register, such certificate to be replaced by a proper entry in the health register at the ap- pointed surgeon's next visit. (d) A health register in a form approved by the chief inspector of factories shall be kept, and shall contain a list of all persons employed in lead processes. The appointed surgeon will enter in the health register the dates and results of his examinations of the persons employed and particulars of any directions given by him. He shall on a prescribed form furnish to the chief inspector of fac- tories on the first day of January in each year a list of the persons suspended by him during the previous year, the cause and duration of such suspension, and the number of examinations made. The health register shall be produced at any time when required by H. M. inspectors of factories or by the certifying surgeon or by the appointed surgeon. 9. Overalls shall be provided for all persons employed in manipulating dry compounds of lead or in pasting. The overalls shall be washed or renewed once every week. 10. The occupier shall provide and maintain — (a) A cloakroom in which workers can deposit clothing put off during work- ing hours. Separate and suitable arrangements shall be made for the storage of the overalls required in regulation 9. (b) A dining room unless the factory is closed during meal hours. 11. No person shall be allowed to introduce, keep, prepare, or partake of any food, drink, or tobacco, in any room in which a lead process is carried on. Suitable provision shall be made for the deposit of food brought by the workers. This regulation shall not apply to any sanitary drink provided by the occupier and approved by the appointed surgeon. 12. The occupier shall provide and maintain for the use of the persons em- ployed in lead processes a lavatory, with soap, nailbrushes, towels, and at least one lavatory basin for every five such persons. Each such basin shall be pro- vided with a waste pipe, or the basins shall be placed on a trough fitted with a waste pipe. There shall be a constant supply of hot and cold water laid onto each basin. Or, in the place of basins the occupier shall provide and maintain troughs of enamel or similar smooth impervious material, in good repair, of a total length of two feet for every five persons employed, fitted with waste pipes, and without plugs, with a sufficient supply of warm water constantly available. The lavatory shall be kept thoroughly cleansed and shall be supplied with a sufficient quantity of clean towels once every day. 13. Before each meal and before the end of the day's work, at least ten minutes, in addition to the regular meal times, shall be allowed for washing to each person who has been employed in the manipulation of dry compounds of lead or in pasting. Provided that if the lavatory accommodation specially reserved for such per- sons exceeds that required by Regulation 12, the time allowance may be pro- portionately reduced, and that if there be one basin or two feet of trough for each such person this regulation shall not apply. 14. Sufficient bath accommodation shall be provided for all persons engaged in the manipulation of dry compounds of lead or in pasting, with hot and cold water laid on, and a sufficient supply of soap and towels. This rule shall not apply if in consideration of the special circumstances of any particular case, the chief inspector of factories approves the use of local public baths when conveniently near, under the conditions (if any) named in such approval. 15. The floors and benches of each workroom shall be thoroughly cleansed daily at a time when no other work is being carried on in the room. 142 Duties of persons employed. 16. All persons employed in lead processes shall present themselves at the appointed times for examination by the appointed surgeon as provided in Regu- lation 8. No person after suspension shall work in a lead process, in any factory or workshop in which electric accumulators are manufactured, without written sanction entered in the health register by the appointed surgeon. 17. Every person employed in the manipulation of dry compounds of lead or in pasting shall wear the overalls provided under Regulation 9. The overalls, when not being worn, and clothing put off during working hours, shall be deposited in the places provided under Regulation 10. 18. No person shall introduce, keep, prepare, or partake of any food, drink (other than any sanitary drink provided by the occupier and approved by the appointed surgeon), or tobacco in any room in which a lead process is carried on. 19. No person employed in a lead process shall leave the premises or partake of meals without previously and carefully cleaning and washing the hands. 20. Every person employed in the manipulation of dry compounds of lead or in pasting shall take a bath at least once a week. 21. No person shall in any way interfere, without the concurrence of the occupier or manager, with the means and appliances provided for the removal of the dust or fumes, and for the carrying out of these regulations. These regulations shall come into force on the 1st day of January, 1904. A. Akers-Douglas, One of His Majesty's Principal Secretaries of State. Home Office, Whitehall, 21st November, 1903. Works of Parts of Works, in Which Lead, Arsenic, or Antimony is Used in the Enameling of Iron Plates. (Form 251 — January, 1906.) Duties of occupiers. 1. They shall provide washing conveniences with a sufficient supply of hot and cold water, soap, nailbrushes, and towels, and take measures to secure that every worker wash face and hands before meals and before leaving the works. 2. They shall provide suitable respirators, overall suits, and head coverings for all workers employed in the processes of grinding, dusting, and brushing. 3. They shall adopt measures on and after the first day of October, 1894, in the dusting and brushing processes for the removal of all superfluous dust, by the use of perforated benches or tables supplied with fans to carry the dust down through the apertures of such benches or tables, the under part of which must be boxed in. 4. They shall provide a sufficient supply of approved sanitary drink, and shall cause the work people to take it. 5. They shall arrange for a medical inspection of all persons employed, at least once a month. They shall see that no female is employed without previous examination and a certificate of fitness from the medical attendant of the works. They shall see that no person who has been absent from work through illness shall be reemployed without a medical certificate to the effect that he or she has recovered. 6. Upon any person employed in the works complaining of being unwell, the occupier shall, with the least possible delay, and at his own expense, give an order upon a doctor for professional attendance and medicine. It is to be understood that this rule will not apply to persons suffering from complaints which have not been contracted in the process of manufacture. 7. They shall provide a place or places free from dust and damp in which the operatives can hang up the clothes in which they do not work. (It is recommended that they shall provide for each female before the day's work begins some light refreshment, such as a half pint of milk and a biscuit.) 143 Duties of persons employed. 8. Every person to whom is supplied a respirator or overall and head covering shall wear the same when at the work for wlii< li su< li arc provided. 9. Every person shall carefully clean and wash hands and face before meals and before leaving the works. 10. No food shall be eaten by any person in any part of the work', except in the apartment specially provided for the purpose. 11. No person may seek employment under an assumed name or under any false pretense. Respirators : A good respirator is a cambric bag with or without a thin flexi- ble wire made to fit over the nose. Sanitary drink suggested : Sulphate of magnesia, 2 oz. ; water, 1 gallon ; essence of lemon, sufficient to flavor. Arthur Whitelegge, H. M. Chief Inspector of Factories. Note. — These rules must be kept posted up in conspicuous places in the factory to which they apply, where they may be conveniently read by the persons em- ployed. Any person who is bound to observe these rules and fails to do so or acts in contravention of them, is liable to a penalty ; and i nsuch case the occupier also is liable to a penalty unless he proves that he has taken all reason- able means by publishing, and to the best of his power, enforcing the rules, to prevent the contravention or non-compliance. Works in Which Lead or Arsenic is Used in the Tinning and Enameling op Metal Hollow Ware and Cooking Utensils. (Form 385 — March 1906.) Duties of occupiers. They shall provide washing conveniences with a sufficient supply of hot and cold water, soap, nailbrushes, and towels, and take measures to secure that every worker wash face and hands before meals and before leaving the works. They shall see that no food is eaten in any room where the process of tinning or enameling is carried on. Duties of persons employed. Every worker shall wash face and hands before meals and before leaving the works. No worker shall eat food in any room where the process of tinning or enamel- ing is carried on. Arthur Whitelegge, H. M. Chief Inspector of Factories. Note. — These rules must be kept posted up in conspicuous places in the fac- tory to which they apply, where they may be conveniently read by the persons employed. Any person who is bound to observe these rules and fails to do so or acts in contravention of them, is liable to a penalty, and in such case the occupier also is liable to a penalty unless he proves that he has taken all reason- able means by publishing, and to the best of his power, enforcing the rules, to prevent the contravention or non-compliance. Processes in the Manufacture of Paints and Colors, and in the Extraction of Arsenic. (Form 249 — June, 1904.) Duties of occupiers. 1. They shall provide washing conveniences, with a sufficient supply of hot and cold water, soap, nailbrushes, and towels, and take measures to secure that 144 every worker wash face and hands before meals, and before leaving the works; and, in addition to the above, sufficient bath accommodation for the use of all persons employed in the manufacture of milan red, vermilionette, or persian red. 2. They shall provide suitable respirators and overall suits kept in a cleanly state, for all workers engaged in any department where dry white lead or ar- senic is used in either the manufacture or paint mixing, and overall suits for those engaged in grinding in water or oil, and for all workers in milan red, vermilionette, or persian red, wherever dust is generated. 3. They shall provide a sufficient supply of approved sanitary drink, which shall be accessible to the workers at all times, and shall cause such approved sanitary drink to be taken daily by workers in any department where white lead or arsenic is used in the manufacture, and shall provide a supply of aperient medicine, which shall be given to the workers, when required, free of charge. 4. No food shall be eaten in any part of the works where white lead or arsenic is used in the manufacture. Duties of persons employed. 5. Every person to whom is supplied a respirator or overall suit shall wear the same when at the special work for which such are provided. 6. Every person shall carefully clean and wash hands and face before meals and before leaving the works. 7. No food shall be eaten in any part of the works in which white lead or arsenic is used in the manufacture. 8. No person shall smoke or use tobacco in any part of the works in which white lead or arsenic is used in the manufacture. Arthur Whitelegge, H. M. Chief Inspector of Factories. Note. — These rules must be kept posted up in conspicuous places in the works to which they apply, where they may be conveniently read by the persons em- ployed. Any person who is bound to observe these rules and fails to do so or acts in contravention of them, is liable to a penalty ; and in such case 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 pre- vent the contravention or non-compliance. Processes in the Mixing and Casting Brass, Gun Metal, Bell Metal White Metal, Delta Metal, Phosphor Bronze, and Manilla Mixture. (Form 271 — February, 1904.) Duties of occupiers. 1. They shall provide adequate means for facilitating, as far as possible, the emission or escape from the shop of any noxious fumes or dust arising from the above-named processes. Such means shall include the provision of traps or of louver gratings in the roof or ceiling of any shop in which such processes, or either of them, is or are carried on; or in case of a mixing or casting shop which is situated under any other shop, there shall be provided an adequate flue or shaft (other than any flue or shaft in connection with a furnace or fire- place) to carry any fumes from the mixing or casting shop, by or through any such shop that may be situated above it. 2. They shall cause all such mixing or casting shops, whether defined as fac- tories or as workshops under the Factory and Workshop Act, 1878, to be cleaned down and limewashed once at least within every twelve months, or once within every six months if so required by notice in writing from H. M. inspector of factories and workshops, dating from the time when these were last thus cleaned down and limewashed; and they shall record the dates of such cleaning down and limewashing in a prescribed form of register. 3. They shall provide a sufficient supply of metal basins, water, and soap, for the use of all persons employed in such mixing or casting shops. 4. They shall not employ, or allow within their factory or workshop the em- M5 ploymcnt of, any woman or female younj'. p< r.on, if] any pfOOCM what'-vrr, in any sucli mixing or casting shopi or in any portion thereof wlix li i-, not entirely separated \>y a. partition extending from the floor to the f state for use in india-rubber works shall be kept, and in it the certifying surgeon will enter the dates and result of his visits, with the number of persons examined, and particulars of any directions given by him. This register shall contain a list of all persons employed in rooms in which bisulphide of carbon is u*ed, and shall be produced at any time when required by H. M. inspector of factories or by the certifying surgeon. II. — Duties of persons employed. 10. No person shall enter the drying room in the ordinary course of work. or perform dipping except in boxes provided with a suction fan carrying the fumes away from the workers. 150 ii. No person shall take any food in any room in which bisulphide of carbon is used. 12. After May i, 1898, no person shall, contrary to the direction of the certify- ing surgeon, given in pursuance of Rule 7, work in any room in which bisulphide of carbon is used. 13. All persons employed in rooms in which bisulphide of carbon is used shall present themselves for periodic examination by the certifying surgeon, as provided in Rule 7. 14. It shall be the duty of all persons employed to report immediately to the employer or foreman any defect which they may discover in the working of the fan or in any appliance required by these rules. Arthur Whitelegge, H. M. Chief Inspector of Factories. Note. — These rules are required to be posted up in conspicuous places in the factory or workshop to which they apply, where they may be conveniently read by the persons employed. Any person who willfully injures or defaces them is liabile to a penalty not exceeding five pounds [$24.33]. Occupiers of factories and workshops, and persons employed therein, who are bound to observe these rules, are liable to penalties in case of noncompliance. (Factory and Workshop Act, 1891, section 9, and Factory and Workshop Act, 1901, sections 85 and 86.) Lucifer Match Factories in Which White or Yellow Phosphorus is Used. (Form 384 — January, 1904.) In these rules "phosphorous process" means mixing, dipping, drying, boxing, and any other work or process in which white or yellow phosphorus is used; and "person employed in a phosphorous process" means any person who is em- ployed in any room or part of the factory where such a process is carried on. "Doubled dipped matches" means wood splints, both ends of which have been dipped in the igniting composition. "Certifying surgeon" means a surgeon appointed under the Factory and Workshop Acts. Any approval or decision given by the chief inspector of factories in pursuance of these rules shall be given in writing, and may at any time be revoked by notice in writing signed by him. Rules 5 (a), 5 (b), 6, 8,and 19, so far as they affect the employment of adult workers, shall not come into force until the 1st day of October, 1900. Duties of employers. 1. No part of a lucifer match factory shall be constructed, structurally altered or newly used, for the carrying on of any phosphorous process, unless the plans have previously been submitted in duplicate to the chief inspector of factories, and unless he shall have approved the plans in writing, or shall not within six weeks from the submission of the plans have expressed his disapproval in writing of the same. , 2. Every room in which mixing, dipping, drying, or boxing is carried on shall be efficiently ventilated by means of sufficient openings to the outer air, and also by means of fans, unless the use of fans is dispensed with by order in writing of the chief inspector; shall contain at least 400 cubic feet of air space for each person employed therein ; and in computing this air space no height above 14 feet shall be taken into account; shall be efficiently lighted; shall have a smooth and impervious floor. A floor laid with flagstone or hard bricks in good repair shall be deemed to constitute a smooth and impervious floor. 3. (a) The processes of mixing, dipping, and drying shall each be done in a separate and distinct room. The process of boxing double-dipped matches or matches not thoroughly dry shall also be done in a separate and distinct room. These rooms shall not communicate with any other part of the factory unless there shall be a ventilated space intervening; nor shall they communicate with one another, except by means of doorways with closely fitting doors, which doors shall be kept shut except when some person is passing through. '5' (b) Mixing shall not be done except in an apparatus, or so arranged, and ventilated by means of a fan, as to prevent the entrance of fun,, into the air of the mixing room. (c) Dipping shall not be done except on a slab provided with an efficient exhaust fan, and with an air inlet between the dipper and the slab, or with a hood, so arranged as to draw the fumes away from the dipper, and to prevent them from entering the air of the dipping room. ((/) Matches that have been dipped ami can not at once be removed to the drying room shall immediately be placed under a hood provided with an efficient exhaust fan, so arranged as to prevent the fumes from entering the air of the room. (c) Matches shall not be taken to a boxing room not arranged in compliance with subsection (/) of this rule until they arc thoroughly dry, and matches shall not be taken to a boxing room that is so arranged until they are dried so far as they can be before cutting down and boxing. (/) Cutting down of double-dipped matches and boxing of matches not thor- oughly dry shall not be done except at benches or tables provided with an effi- cient exhaust fan, so arranged as to draw the fumes away from the worker and prevent them from entering the air of the boxing room. Provided that the foregoing rule shall not prevent the employment of any mechanical arrangement for carrying on any of the above-mentioned processes if the same be approved by the chief inspector as obviating the use of hand labor, and if it be used subject to the conditions (if any) specified in such approval. Provided further that if the chief inspector shall, on consideration of the special circumstances of any particular case, so approve in writing, all or any of the provisions of the foregoing rule may be suspended for the time named in such approval in writing. 4. Vessels containing phosphorous paste shall, when not actually in use, be kept constantly covered, and closely fitting covers or damp flannels shall be provided for the purpose. 5. (a) For the purposes of these rules the occupier shall appoint, subject to the approval of the chief inspector, a duly qualified and registered dentist, herein termed the appointed dentist. It shall be the duty of the appointed dentist to suspend from employment in any phosphorous process any person whom he finds to incur danger of phos- phorous necrosis by reason of defective conditions of teeth or exposure of the jaw. (b) No person shall be newly employed in a dipping room for more than twenty-eight days, whether such days are consecutive or not, without being examined by the appointed dentist. (c) Every person employed in phosphorous process, except persons em- ployed only as boxers of wax vestas or other thoroughly dry matches, shall be examined by the appointed dentist at least once in every three months. (rf) Any person employed in the factory complaining of toothache, or a pain or swelling of the jaw, shall at once be examined by the appointed dentist. (e) When the appointed dentist has reason to believe that any person em- ployed in the factory is suffering from inflammation or necrosis of the jaw, or is in such a state of health as to incur danger of phosphorous necrosis, be shall at once direct the attention of the certifying surgeon and occupier to the case. Thereupon such person shall at once be examined by the certifying surgeon. 6. No person shall be employed in a phosphorous process after suspension by the appointed dentist; or after the extraction of a tooth; or after any opera- tion involving exposure of the jaw bone: or after inflammation or necrosis of the jaw; or after examination by the appointed dentist in pursuance of Rule 5 (d) ; or after reference to the certifying surgeon in pursuance of Rule 5 (e), unless a certificate of fitness has been given, after examination, by signed entry in the health register, by the appointed dentist or by the certifying surgeon in cases referred to him under Rule 5 (c). 7. A health register, in a form approved by the chief inspector of factories, shall be kept by the occupier, and shall contain a complete list of all persons employed in each phosphorous process, specifying with regard to each such per- son the full name, address, age when first employed, and date of first employment The certifying surgeon will enter in the health register the dates and results 152 of his examinations of persons employed in phosphorous processes, and partic- ulars of any directions given by him. The appointed dentist will enter in the health register the dates and results of his examinations of the teeth of persons employd in phosphorous processes, and particulars of any directions given by him, and a note of any case referred by him to the certifying surgeon. The health register shall be produced at any time when required by H. M. inspectors of factories, or by the certifying surgeon, or by the appointed dentist. 8. Except persons whose names are on the health register mentioned in Rule 7, and in respect of whom certificates of fitness shall have been granted, no person shall be newly employed in any phosphorous process for more than 28 days, whether such days are consecutive or not, without a certificate of fitness, granted after examination by the certifying surgeon, by signed entry in the health register. This rule shall not apply to persons employed only as boxers of wax vestas or other thoroughly dry matches. 9. The occupier shall provide and maintain sufficient and suitable overalls for all persons employed in phosphorous processes, except for persons employed only as boxers of wax vestas or other thoroughly dry matches, and shall cause them to be worn as directed in Rule 20. At the end of every day's work they shall be collected and kept in proper custody in a suitable place set apart for the purpose. They shall be thoroughly washed every week, and suitable arrangements for this purpose shall be made by the occupier. 10. The occupier shall provide and maintain — (a) a dining room, and (b) a cloak room in which workers can deposit clothing put off during work- ing hours. 11. No person shall be allowed to prepare or partake of any food or drink in any room in which phosphorous process is carried on, nor to bring any food or drink into such room. 12. The occupier shall provide and maintain for the use of the workers a lavatory, with soap, nailbrushes, towels, and at least one lavatory basin for every five persons employed in any phosphorous process. Each such basin shall be fitted with a waste pipe. There shall be a constant supply of hot and cold water laid on to each basin. Or, in the place of basins, the occupier shall provide and maintain enamel or galvanized iron troughs, in good repair, of a total length of 2 feet for every five persons employed, fitted with waste pipes and without plugs, with a sufficient supply of warm water constantly available. The lavatory shall be kept thoroughly cleansed, and shall be supplied with a sufficient quantity of clean towels twice in each day. There shall, in addition, be means of washing in close proximity to the workers in any department, if so required in writing by the inspector in charge of the district. 13. The occupier shall provide for the use of every person employed in a phosphorous process an antiseptic mouth wash approved by the appointed dentist, and a sufficient supply of glasses or cups. 14. The floor of each room in which a phosphorous process is carried on shall be cleared of waste at least once a day, and washed at least once a week. 15. A printed copy of these rules shall be given to each person on entering upon employment in a phosphorous process. Duties of persons employed. 16. No person shall work in a mixing, dipping, drying, or boxing room under other conditions than those prescribed in Rule 3. 17. No person shall allow a vessel containing phosphorous paste to remain uncovered except when actually in use. 18. All persons employed in a phosphorous process shall present themselves at the appointed times for examination by the certifying surgeon and appointed dentist, as provided in Rules 5, 6, and 8. 19. Every person employed in a phosphorous process and suffering from 153 toothache or swelling of the jaw; or having had a tooth extracted 01 having undergone any oilier operation involving exposure of the jaw, ihall al once inform the occupier, and shall noi resume employment in a phosphor* whli. ..i a certificate of Eitneaa from the appointed dentist, aa provided in Rule 6. No person after suspension l>y the appointed denti i, or after reference to 'lie certifying surgeon, shall resume employment in a phosphorous process without a certificate oi fitness, as provided in Rule 6. 20. livery person employed in a pliosphoion process for whom the occupier is required hy Rule to provide overalls shall wear while at work the overalls SO provided. 21. Every person employed in a phosphorous process shall, before partaking of meals or leaving the premises, deposit the overalls in the place appointed by the occupier for the purpose, and shall thoroughly wash in the lav. 22. No person shall prepare or partake of food or drink in any room in which a phosphorous process is carried on, or bring any food or drink into such room. 23. No person shall in any way interfere, without the knowledge and concur- rence of the occupier or manager, with the means and appliances provided for the removal of dust and fumes. 24. Foremen and forewomen shall report to the manager any instance coming under their notice of a worker neglecting to observe these rules. Arthur Wiiitelegce, Chief Inspector of Factories. April, 1900. Note. — These rules must be kept posted up in conspicuous places in the factory to which they apply, where they may be conveniently read by the person em- ployed. Any person who is bound to observe these rules and fails to do so or acts in contravention of them is liable to a penalty; and in such cases the occu- pier also is liable to a penalty unless he proves that he has taken all reason- able means by publishing, and to the best of his power, enforcing the rules to prevent the contravention or noncompliance. Felt Hats. Whereas the manufacture of felt hats with the aid of inflammable solvent has been certified in pursuance of section 79 of the Factory and Workshop Act, 1901, to be dangerous, I hereby, in pursuance of the power conferred on me by that act, make the following regulations, and direct that they shall apply to all fac- tories and workshops in which any inflammable solvent is used in the manu- facture of felt hats : 1. Every proofing room and every stove or drying room in which an inflam- mable solvent is evaporated shall be thoroughly ventilated to the satisfaction of the inspector for the district, so as to carry off as far as possible the inflammable vapor. 2. The number of wet spirit-proofed hat bodies allowed to be in a proofing room at any one time shall not exceed the proportion of one hat for each 15 cubic feet of air space ; and in no stove, whilst the first drying of any spirit- proofed hats is being carried on, shall the number of hat bodies of any kind exceed a proportion of one hat for each 12 cubic feet of air space. A notice stating the dimensions of each such room or stove in cubic feet and the number of spirit-proofed hats allowed to be therein at any one time shall be kept constantly affixed in a conspicuous position. 3. Spirit-proofed hats shall be opened out singly and exposed for one hour before being placed in the stove. This requirement shall not apply in the case of a stove which contains no fire or artificial light capable of igniting inflam- mable vapor, and which is so constructed and arranged as, in the opinion of the inspector for the district, to present no risk of such ignition from external fire or light. 4. The above rules, in so far as they affect drying stoves, shall not apply to the process of drying hat bodies where the solvent is recovered in a closed oven or chamber fitted with safe and suitable apparatus for the condensation of the solvent 154 5- No person shall smoke in any room or place in which inflammable solvent is exposed to the air. These regulations shall come into force on the ist day of October, 1902. A. Akers-Douglas, One of His Majesty's Principal Secretaries of State. Whitehall, 12th August, 1902. Special Rules for the Handling of Dry and Drysalted Hides and Skins Imported from China or from the West Coast of India. (Form 48(3 — February, 1906.) Duties of occupiers. 1. Proper provision to the reasonable satisfaction of the inspector in charge of the district shall be made for the keeping of the workmen's food and clothing outside any room or shed in which any of the above-described hides or skins are unpacked, sorted, packed, or stored. 2. Proper and sufficient appliances for washing, comprising soap, basins, with water laid on, nailbrushes and towels, shall be provided and maintained for the use of the workmen, to the reasonable satisfaction of the inspector in charge of the district. 3. Sticking plaster, and other requisites for treating scratches and slight wounds shall be kept at hand, available for the use of the persons employed. 4. A copy of the appended notes shall be kept affixed with the rules. Duties of persons employed. 5. No workman shall keep any food, or any article of clothing other than those he is wearing, in any room or shed in which any of the above-described hides or skins are handled. He shall not take any food in any such room or shed. 6. Every workman having any open cut or scratch or raw surface, however trifling, upon his face, head, neck, arm, or hand shall immediately report the fact to the foreman, and shall not work on the premises until the wound is healed or is completely covered by a proper dressing after being thoroughly washed. Arthur Whitelegge, Chief Inspector of Factories. Chas. T. Ritchie, One of His Majesty's Principal Secretaries of State. August, 1901. Note i. — These rules must be kept posted up in conspicuous places in the factory to which they apply, where they may be conveniently read by the per- sons employed. Any person who is bound to observe these rules and fails to do so, or acts in contravention of them, is liable to a penalty; and 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 the contravention or noncompliance. Note 2. — The danger against which these rules are directed is that of anthrax — a fatal disease affecting certain animals, which may be conveyed from them to man by the handling of hides of animals which have died of the disease. The germs of the disease, (anthrax sores) are found in the dust and in the sub- stance of the hide, and may remain active for years. In this country anthrax is rare, and precautions are taken to prevent infected hides from coming into the market, consequently there is little danger in handling the hides of animals slaughtered in the United Kingdom ; but in Russia, China, and the East Indies, and in many other parts of the world, the disease is common, and infected hides (which do not differ from others in appearance) are often shipped to British ports. Hence in handling foreign dry hides the above rules should be carefully observed. Wet salted hides are free from dust and less risk is incurred in hand- ling them. 11 • The disease is communicated to man sometimes by breathing or swallowing 155 the dust from an infected hide, 1ml RlUCh more usually by ill' poi ''ii lodging in some point where the skin is broken -such as a fresh scratch 01 cut >,r a scratched pimple, or even chapped hands. 'I his happens mo I readily on the uncovered parts of the body, the hand, arm, face, ,-md most frequently of all on the neck — owing either to an infected hide rubbing again \\ the bare skin, or to dust from such hide alighting on the raw mi in. But a raw surface cov- ered by clothing is not free from risk, for dust lodging upon the dottu sooner or later work its way to the skin beneath. Infection may also be brought about by rubbing or scratching a pimple with hand or nail carrying the anthrax poison. The first symptoms of anthrax is usually a small inflamed swelling like a pimple or boil, often quite painless, which extends and in a few days becomes black at the center and surrounded by other "pimples." The poison is now liable to be absorbed into the system and will cause risk of life, which can be avoided only by prompt and effective medical treatment in the early stage while the poison is still confined to the pimple. Hence it is of the utmost importance that a doctor should at once be consulted if there is any suspicion of infection. Note. — Suitable overalls, protecting the neck and arms, as well as ordinary clothing, add materially to the safety of the workmen, and should be provided and worn, where practicable, if dangerous hides are handled. They should be discarded on cessation of woik. Similarly for the protection of the hands, gloves should be provided and worn where the character of the work permits. Wool and Hair Sorting. Whereas the processes of sorting, willying, washing, and combing and carding wool, goat-hair, and camel-hair and processes incidental thereto have been certified, in pursuance of section 79 of the Factory and Workshop Act, 1901, to be dangerous : I hereby in pursuance of the powers conferred on me by that act make the fol- lowing regulations, and direct that they shall apply to all factories and workshops in which the said processes are carried on, and in which the materials named in the schedules are used. It shall be the duty of the occupier to comply with Regulations 1 to 16. It shall be the duty of all persons employed to comply with Regulations 17 to 23. These regulations shall come into force on the 1st of January, 1906, except that Regulations 2 and 8 shall come into force until the 1st of April, 1906. Definition. For the purpose of Regulations 2, 3, and 18 " opening of wool or hair means the opening of the fleece, including the untying or cutting of the knots, or, if the material is not in fleece, the opening out for looking over or classing purposes. Duties of occupiers. 1. No bale of wool or hair of the kinds named in the schedules shall be opened for the purpose of being sorted or manufactured, except by men skilled in judging the condition of the material. No bale of wool or hair of the kinds named in Schedule A shall be opened except after thorough steeping in water. 2. No wool or hair of the kinds named in Schedule B shall be opened except (a) after steeping in water, or (b) over an efficient opening screen, with me- chanical exhaust draft, in a room set apart for the purpose, in which no other work than opening is carried on. For the purpose of this regulation, no opening screen shall be deemed to be efficient unless it complies with the following conditions : (a) The area of the screen shall in the case of existing screens, be not less than 11 square feet, and in the case of screens hereafter erected be not less than 12 square feet, nor shall its length or breadth be less than 3 T 4 feet. (b) At no point of the screen within 18 inches from the center shall the velocity of the exhaust draft be less than 100 linear feet per minute. 3. All damaged wool or hair or fallen fleeces or skin wool or hair, if of the 156 kinds named in the schedules, shall when opened be damped with a disinfectant and washed without being willowed. 4. No wool or hair of the kinds named in schedules B or C shall be sorted except over an efficient sorting board, with mechanical exhaust draft, and in a room set apart for the purpose, in which no work is carried on other than sorting and the packing of the wool or hair therein. No wool or hair of the kinds numbered (1) and (2) in Schedule A shall be sorted except in the damp state and after being washed. No damaged wool or hair of the kinds named in schedules shall be sorted except after being washed. For the purpose of this regulation, no sorting board shall be deemed to be efficient unless it complies with the following conditions : The sorting board shall comprise a screen of open wirework, and beneath it at all parts a clear space not less than 3 inches in depth. Below the center of the screen there shall be a funnel, measuring not less than 10 inches across the top, leading to an extraction shaft, and the arrangements shall be such that all dust falling through the screen and not carried away by the exhaust can be swept directly into the funnel. The draft shall be maintained in constant efficiency whilst the sorters are at work, and shall be such that not less than 75 cubic feet of air per minute are drawn by the fan from beneath each sorting board. 5. No wool or hair of the kinds named in the schedules shall be willowed except in an efficient willowing machine, in a room set apart for the purpose, in which no work other than willowng s carred on. For the purpose of this regulation, no willowing machine shall be deemed to be efficient unless it is provided with mechanical exhaust draft so arranged as to draw the dust away from the workmen and prevent it from entering the air of the room. 6. No bale of wool or hair shall be stored in a sorting room; nor any wool or hair except in a space effectually screened off from the sorting room. No wool or hair shall be stored in a willowing room. 7. In each sorting room, and exclusive of any portion screened off, there shall be allowed an air space of at least 1,000 cubic feet for each person employed therein. 8. In each room in which sorting willowing, or combing is carried on, suit- able inlets from the open air, or other suitable source, shall be provided and arranged in such a way that no person employed shall be exposed to a direct draft from any air inlet or to any draft at a temperature of less than 50° F. The temperature of the room shall not, during working hours, fall below 50 F. 9. All bags in which wool or hair of the kinds named in the schedules has been imported shall be picked clean and not brushed. 10. All pieces of skin, scab, and clippings or shearings shall be removed daily from the sorting room, and shall be disinfected or destroyed. 11. The dust carried by the exhaust draft from opening screens, sorting boards, willowing or other dust extracting machines and shafts shall be discharged into properly constructed receptacles, and not into the open air. Each extracting shaft and the space beneath the sorting boards and opening screens shall be cleaned out at least once in every week. The dust collected as above, together with the sweepings from the opening, sorting, and willowing rooms, shall be removed at least twice a week and burned. The occupier shall provide and maintain suitable overalls and respirators to be worn by the persons engaged in collecting and removing the dust. Such overalls shall not be taken out of the works or warehouse, either for washing, repairs, or any other purpose, unless they have been steeped over- night in boiling water or a disinfectant. 12. The floor of every room in which opening, sorting, or willowing is carried on shall be thoroughly sprinkled daily with a disinfectant solution after work has ceased for the day, and shall be swept immediately after sprinkling. 13. The walls and ceilings of every room in which opening, sorting, or willow- ing is carried on shall be limewashed at least once a year, and cleansed at least once within every six months, to date from the time when they were last cleansed. 14. The following requirements shall apply to every room in which unwashed wool or hair of the kinds named in the schedules after being opened for sorting, manufacturing, or washing purposes is handled or stored. '57 (a) Sufficient and suitable washing accommodation thai] l"- provided outside the rooms and maintained for the use of all persons employed in such rooms. The washing conveniences sliall comprise SOap, iiailbr ir.li< I, towels, and a< one basin for every live persons employed as above, each basin being fitted with a waste pipe and having a constant supply of water laid on. (b) Suitable places sliall be provided outside the rooms in which persons employed in such rooms can deposit food and clothing pUl oil during working hours. (c) No person shall be allowed to prepare or partake of food in any such room. Suitable and sufficient meal room accommodation shall be provided for workers employed in such rooms. (d) No person having any open cut or sore shall be employed in any such room. The requirements in paragraph (c) shall apply also to every room in which any wool or hair of the kinds named in the schedules is carded or stored. 15. Requisites for treating scratches and slight wounds shall be kept at hand. 16. The occupier shall allow any H. M. inspectors of factories to take at any time, for the purpose of examination, sufficient samples of any wool or hair used on the premises. Duties of persons employed. 17. No bale of wool or hair of the kinds named in the schedules shall be opened otherwise than as permitted by paragraph 1 of Regulation 1, and no bale of wool or hair of the kinds named in Schedule A shall be opened except after thorough steeping in water. If on opening a bale any damaged wool or hair of the kinds named in the schedules is discovered, the person opening the bale shall immediately report the discovery to the foreman. 18. No wool or hair of the kinds named in Schedule B shall be opened other- wise than as permitted by Regulation 2. 19. No wool or hair of the kinds named in the schedules shall be sorted other- wise than as permitted by Regulation 4. 20. No wool or hair of the kinds named in the schedules shall be willowed except as permitted by Regulation 5. 21. Every person employed in a room in which unwashed wool or hair of the kinds named in the schedules is stored or handled shall observe the following requirements : (a) He shall wash his hands before partaking of food, or leaving the premises. (b) He shall not deposit in any such room any article of clothing put off dur- ing working hours. He shall wear suitable overalls while at work", and shall remove them before partaking of food or leaving the premises. (c) If he has any open cut or sore, he shall report the fact at once to the fore- man, and shall not work in such a room. No person employed in any such room or in any room in which wool or hair of the kinds named in the schedule is either carded or stored shall prepare or partake of any food therein, or bring any food therein. 22. Persons engaged in collecting or removing dust shall wear the overalls as required by Regulation 11. Such overalls shall not be taken out of the works or warehouse either for washing, repairs, or any other purpose, unless they have been steeped overnight in boiling water or a disinfectant. 23. If any fan, or any other appliance for the carrying out of these regula- tions, is out of order, any workman becoming aware of the defect shall imme- diately report the fact to the foreman. H. J. Gladstone. One of Her Majesty's Principal Secretaries of State. Home Office, Whitehall, 12th December, 1905. Schedule A. (Wool or hair required to be opened either after steeping or over an efficient opening screen.) 158 r. Van mohair. 2. Persian locks. 3. Persian or so-called Persian (including Karadi and Bagdad) if not subjected to the process of sorting or willowing. Schedule B. (Wool or hair required to be opened either after steeping or over an efficient opening screen.) Alpaca. Pelitan. East Indian cashmere. Russian camel hair. Pekin camel hair. Persian or so-called Persian (including Karadi and Bagdad) if subjected to the process of sorting or willowing. Schedule C. (Wool or hair not needing to be opened over an opening screen but required to be sorted over a board provided with downward draught.) All mohair other than van mohair. Note. — The danger against which these regulations are directed is that of anthrax — a fatal disease affecting certain animals, which may be conveyed from them to man by the handling of wools or hairs from animals which have died of the disease. The germs of the disease (anthrax spores) are found in the dust attaching to the wool, or in the excrement, and in the substance of the pieces of skin, and may remain active for years. In this country and Australia anthrax is rare, consequently there is little danger in handling wools from the sheep of these two countries, but in China, Persia, Turkey, Russia, the East Indies, and in many other parts of the world, the disease is common, and infected fleeces or locks (which may not differ from others in appearance) are often shipped to Great Britain. Hence, in handling foreign dry wools and hair, the above regu- lations should be carefully observed. Greasy wools are comparatively free from dust and therefore little risk is incurred in handling them. The disease is communicated to man sometimes by breathing or swallowing the dust from these wools or hair, and sometimes by the poison lodging in some point where the skin is broken, such as a fresh scratch or cut, or a scratched pimple, or even chapped hands. This happens more readily on the uncovered parts of the body, the hand, arm, face, and most frequently of all, on the neck, owing either to infected wool rubbing against the bare skin, or to dust from such wool alight- ing on the raw surface. But a raw surface covered by clothing is not free from risk, for the dust lodging upon the clothes may sooner or later work its way to the skin beneath. Infection may also be brought about by rubbing or scratching a pimple with hand or nail carrying the anthrax poison. Use of the nailbrush, and frequent washing and bathing of the whole body, especially of the arms, neck, and head, will lessen the chance of contracting anthrax. The first symptom of anthrax is usually a small inflamed swelling like a pimple or boil — often quite painless — which extends, and in a few days becomes black at the center, and surrounded by other "pimples." The poison is now liable to be absorbed into the system, and will cause risk of life, which can be avoided only by prompt and effective medical treatment in the early stage, while the poison is still confined to the pimple. Hence, it is of the utmost importance that a doctor should be at once consulted if there is any suspicion of infection. Flax and Tow Spinning and Weaving. Whereas the processes of spinning and weaving flax and tow and the pro- cesses incidental thereto have been certified in pursuance of section 79 of the Factory and Workshop Act, 1901, to be dangerous: I hereby in pursuance of the powers conferred on me by that act make the following regulations, and direct that they shall apply to all factories in which '59 the processes named above are carried on, and to 'ill workshops in which the processes of roughing, sorting, or hand hackling of flax 01 tot* are carried on. These regulations shall cfimc inw, tone on the i il day oi February, 1907 Provided that in rase of all rooms in which roughing or hand hackling is now carried on, and in which there is respectively (a) no System of local me- chanical exhaust ventilation, or (b) no artificial meant of regulating the temper* aturc, Regulations 2 and 3, respectively, shall no1 come into force until the 1 t day of February, 1908. Definitions. In these regulations — "Degrees" means degrees on the Fahrenheit scale. "Roughing, sorting, hand-hackling, machine-hackling, carding, and preparing" mean those processes in the manufacture of flax or tow. It shall be the duty of the occupier to observe Part I of these regulations. It shall be the duty of all persons employed to observe Part II of these regulations. Part I. — Duties of occupiers. 1. In every room in which persons are employed the arrangements shall be such that during working hours the proportion of carbonic acid in the air of the room shall not exceed 20 volumes per 10,000 volumes of air at any time when gas or oil is used for lighting (or within one hour thereafter) or 12 volumes per 10,000 when electric light is used (or within one hour thereafter) or 9 vol- umes per 10,000 at any other time. Provided that it shall be a sufficient compliance with this regulation if the proportion of carbonic acid in the air of the room does not exceed that of the open air outside by more than 5 volumes per 10,000 volumes of air. 2. In every room in which roughing, sorting, or hand-hackling is carried on, and in every room in which machine-hackling, carding or preparing is carried on, and in which dust is generated and inhaled to an extent likely to cause injury to the health of the workers, efficient exhaust and inlet ventilation shall be pro- vided to secure that the dust is drawn away from the workers at, or as near as reasonably possible to, the point at which it is generated. For the purposes of this regulation the exhaust ventilation in the case of hand-hackling, roughing, or sorting shall not be deemed to be efficient if the exhaust opening at the back of the hackling pins measures less than 4 inches across in any direction, or has a sectional area of less than 50 square inches, or if the linear velocity of the draught passing through it is less than 400 feet per minute at any point within a sectional area of 50 square inches. 3. In every room in which hand-hackling, roughing, sorting, machine-hackling, carding, or preparing is carried on, an accurate thermometer shall be kept af- fixed; and the arrangements shall be such that the temperature of the room shall not at any time during working hours where hand-hackling roughing, or machine- hackling is carried on, fall below 50 degrees, or where sorting, carding, or pre- paring is carried on below 55 degrees ; and that no person employed shall be exposed to a direct draft from any air inlet, or to any draft at a temperature of less than 50 degrees. Provided that it shall be a sufficient compliance with this regulation if the heating apparatus be put into operation at the commencement of work, and if the required temperature be maintained after the expiration of one hour from the commencement of work. 4. In every room in which wet spinning is carried on, or in which artificial humidity of air is produced in aid of manufacture, a set of standardized wet and dry bulb thermometers shall be kept affixed in the center of the room or in such other position as may be directed by the insepctor of the district by notice in writing, and shall be maintained in correct working order. Each of the above thermometers shall be read between 10 and 11 a. m. on every day that any person is employed in the room, and again between 3 and 4 p. m. on every day that any person is employed in the room after 1 p. m., and each reading shall be at once entered on the prescribed form. i6o The form shall be hung up near the thermometers to which it relates, and shall be forwarded, duly tilled in, at the end of each calendar month to the in- spector of the district. Provided that this part of this regulation shall not apply to any room in which the difference of reading between the wet and dry bulb thermometers rs never less than 4 degrees, if notice of intention to work on that system has been given in the prescribed form to the inspectors for the district, and a copy of the notice is kept affixed in the room to which it applies. 5. The humidity of the atmosphere of any room to which Regulation 4 applies shall not at any time be such that the difference between the readings of the wet and dry bulb thermometers is less than 2 degrees. 6. No water shall be used for producing humidity of the air, or in wet-spinning troughs, which is liable to cause injury to the health of the persons employed or to yield effluvia ; and for the purpose of this regulation any water which ab- sorbs from acid solution of permanganate of potash in four hours at 60 degrees more than 0.5 grain of oxygen per gallon of water, shall be deemed to be liable to cause injury to the health of the persons employed. 7. Efficient means shall be adopted to prevent the escape of steam from wet- spinning troughs. 8. The pipes used for the introduction of steam into any room in which the temperature exceeds 70 degrees or for heating the water in any wet-spinning trough, shall, so far as they are within the room and not covered by water, be as small in diameter and as limited in length as is reasonably practicable, and shall be effectively covered with nonconducting material. 9. Efficient splash guards shall be provided and maintained on all wet-spin- ning frames of 2^4 inch pitch and over, and on all other wet-spinning frames unless waterproof skirts, and bibs of suitable material are provided by the occupier and worn by the workers. Provided that if the chief inspector is satisfied with regard to premises in use prior to 30th June, 1905, that the structural conditions are such that splash guards can not conveniently be used, he may suspend the requirements as to splash guards. Such suspension shall only be allowed by certificate in writing, signed by the chief inspector, and shall be subject to such conditions as may be stated in the certificate. 10. The floor of every wet-spinning room shall be kept in sound condition, and drained so as to prevent retention or accumulation of water. 11. There shall be provided for all persons employed in any room in which wet-spinning is carried on, or in which artificial humidity of air is produced in air of manufacture, suitable and convenient accommodation in which to keep the clothing taken off before starting work, and in the case of building erected after 30th June, 1905, in which the difference between the readings of the wet and dry bulb thermometers is at any time less than 4 degrees, such accommoda- tion shall be provided in cloak-rooms ventilated and kept at a suitable tempera- ture and situated in or near the workrooms in question. 12. Suitable and efficient respirators shall be provided for the use of the persons employed in machine-hackling, preparing, and carding. Part II. — Duties of persons employed. 13. All persons employed on wet-spinning frames without efficient splash guards shall wear the skirts and bibs provided by the occupier in pursuance of Regulation 9. 14. No person shall in any way interfere, without the concurrence of the occupier or manager, with the means and appliances provided for ventilation, or for the removal of dust, or for the other purposes of these regulations. H. J. Gladstone, One of His Majesty's Principal Secretaries of State. Home Office, Whitehall, 20th February, 1906. File Cutting by Hand. Whereas the process of file cutting by hand has been certified in pursuance of section 79 of the Factory and Workshop Act, 1901, to be dangerous: I hereby, in pursuance of the powers conferred on me by that act, make the i6i following regulations, and direct that they shall apply to ill factor!* and work- shops (including tenement factories and tenement workshops) or parts thereof in which the process of file cutting by hand is carried on : Provided thai the ' In'f inspector of factories may by certificate in writing exempt from all or any of these regulations any factory or workshop in wlm h In- is Satisfied thai the beds used are of such composition as not to entail danger to the health of the ]<■ employed. 1. The number of stocks in any room shall not !><■ more than one Stock for every 350 cubic feet of air space in the room; and in calculating air 'pace for the purpose of this regulation any space more than 10 feet above the floor of the room shall not be reckoned. 2. After the 1st day of January, 1904, the distance between the Stocks mea Bred from the center of one stock to the center of the next shall not be less than 2 feet 6 inches, and after the 1st day of January, 1905, the said distance shall not be less than 3 feet. 3. Every room shall have a substantial floor, the whole of which shall be cov- ered with a washable material, save that it shall be optional to leave a space not exceeding 6 inches in width round the base of each stock. The floor of every room shall be kept in good repair. 4. Efficient inlet and outlet ventilators shall be provided in every room. The inlet ventilators shall be so arranged and placed as not to cause a direct draft of incoming air to fall on the workmen employed at the stocks. The ventilators shall be kept in good repair and in working order. 5. No person shall interfere with or impede the working of the ventilators. 6. Sufficient and suitable washing conveniences shall be provided and main- tained for the use of the file cutters. The washing conveniences shall be under cover and shall comprise at least one fixed basin for every ten or less stocks. Every basin shall be fitted with a waste pipe discharging over a drain or into some receptacle of a capacity at least equal to one gallon for every file cutter using the basin. Water shall be laid on to every basin either from the main or from a tank of a capacity of not less than V/ 2 gallons to every worker supplied from such tank. A supply of clean water shall be kept in the said tank while work is going on at least sufficient to enable every worker supplied from such tank to wash. 7. The walls and ceiling of every room, except such parts as are painted or varnished or made of glazed brick, shall be limewashed once in every six months ending the 30th of June and once in every six months ending the 31st of December. 8. The floor and such parts of the walls and ceiling as are not limewashed and the benches shall be cleansed once a week. 9. If the factory or workshop is situated in a dwelling house the work of file cutting shall not be carried on in any room which is used as a sleeping place or for cooking or eating meals. 10. Every file cutter shall when at work wear a long apron reaching from the shoulders and neck to below the knees. The apron shall be kept in a cleanly state. 11. A copy of these regulations and an abstract of the provisions of the Factory and Workshop Act, 1901, shall be kept affixed in the factory or workshop in a conspicuous place. 12. It shall be the duty of the occupier to carry out Regulations 1, 2, 3. 4. 6. 7, and 11; except that, in any room in a tenement factory or tenement workshop which is let to more than one occupier, it shall be the duty of the owner to carry out these regulations, except the last clause of Regulation 6, which shall be carried out by the occupiers. It shall be the duty of the occupier or occupiers to carry out Regulation 8. It shall be the duty of the occupier or occupiers and of every workman to observe Regulations 5, 9, and 10. These regulations shall come into force on the 1st day of September, 1903. A. Akers-Douglas, One of His Majesty's Principal Secretaries of State. Home Office, Whitehall, igth June, 1903. 1 62 Special Rules for the Bottling of Aerated Water. (Form 273 — A 1-3-01.) Duties of occupiers. 1. They shall provide all bottlers with face guards, masks, or veils of wire gauze. They shall provide all wirers, sighters, and labelers with face guards, masks, or veils of wire gauze, or goggles. 2. They shall provide all bottlers with full-length gauntlets for both arms. They shall provide all wirers, sighters, and labelers with gauntlets for both arms, protecting at least half of the palm and the space between the thumb and forefinger. 3. They shall cause all machines for bottling to be constructed, so placed, or so fenced, as to prevent as far as possible, during the operation of filling or corking, a fragment of a bursting bottle from striking any bottler, wirer, sighter, labeler, or washer. Duties of persons employed. 4. All bottlers shall, while at work, wear face guards, masks, or veils of wire gauze. All wirers, sighters, and labelers shall, while at work, wear on both arms gauntlets protecting at least half of the palm and the space between the thumb and forefinger; except labelers when labeling bottles standing in cases. Arthur Whitelegge, H. M. Inspector of Factories. August, 1897. These rules are required to be posted up in conspicuous places in the factory or workshop to which they apply, where they may be conveniently read by the persons employed therein, who are bound to observe any special rules, are liable to a penalty of five pounds [$24.33]. Occupiers of factories and workshops, and persons employed therein, who are bound to observe any special rules, are liable to penalties for non-compliance (Factory and Workshop Act, 1891, sections 9 and 11). The employer is required to provide the articles mentioned in the rules, and to take all reasonable precautions to the best of his power to enforec their use, but the responsibility for the actual wearing of them rests with the person employed. Spinning by Self-Acting Mules. Whereas certain machinery used in the process of spinning in textile factories, and known as self-acting mules, has been certified in pursuance of section 79 of the Factory and Workshop Act, 1901, to be dangerous to life and limb: I hereby, in pursuance of the powers conferred on me by that act, make the following regulations, and direct that they shall apply to all factories or parts thereof in which the process of spinning by means of self-acting mules is car- ried on : 1. In these regulations the term "minder" means the person in charge of a self-acting mule for the time being. 2. Save as hereinafter provided it shall be the duty of the occupier of a factory to observe Part I of these regulations; provided that it shall be the duty of the owner (whether or not he is one of the occupiers) of a tenement factory to observe Part I of these regulations, except so far as relates to such parts of the machinery as are supplied by the occupier. It shall be the duty of the persons employed to observe Part II of these regulations, but it shall be the duty of the occupier, for the purpose of enforcing their observance, to keep a copy of the regulations in legible characters affixed in every mule room, in a conspicuous position where they may be conveniently read. Part I. — Duties of occupiers. 3. After January 1st, [906, the following part* of > I registered tonnage this regulation shall nol apply if and while the condition that it is possible without undue risk to pass to and from the 'hip without the aid of any special appliances. 5. If a ship is alongside any other ship, vessel, or boat, and persons employed have to pass from one to tin- other, safe means of aCCC hall he provided for their use, unless the conditions are such that it i poi ible to pa from one to the other without undue risk without the aid of any special appliance. If one of such ships, vessel, or boats is a sailing barge, flat, keel, lighter or other similar vessel of relatively low free board the means of access shall he pro- vided by the ship which has the higher free hoard. 6. If the depth from the top of the coamings to the bottom of the hold ex- ceeds six feet there shall he maintained safe means of access by ladder or steps from the deck to the hold in which work is being carried on, with lecure hand- hold and foot-hold continued to the top of the coamings. In particular such access shall not be deemed to be safe : (a) Unless the ladders between the lower decks arc in the same line as the ladder from the main deck, if the same is practicable having regard to the posi- tion of the lower hatchway or hatchways. (b) Unless the cargo is stowed sufficiently far from the ladder to leave at each rung of the ladder sufficient room for a man's feet. (c) If there is not room to pass between a winch and the coamings at the place where the ladder leaves the deck. (d) If the ladder is recessed under the deck more than is reasonably necessary to keep the ladder clear of the hatchway. 7. When the processes are being carried on between one hour after sunset and one hour before sunrise («) the places in the hold and on the decks where work is being carried on, and (b) the means of access provided in pursuance of Reg- ulations 4 and 5, shall be efficiently lighted, due regard being had to the safety of the ship and cargo, of all persons employed and of the navigation of other vessels and to the duly approved by-laws or regulations of any authority having power by statute to make by-laws or regulations subject to approval by some other authority. 8. All iron fore and aft beams and thwart ship beams used for hatchway cov- ering shall have suitable gear for lifting them on and off without it being neces- sary for any person to go upon them to adjust such gear. 9. All machinery and chains and other gear used in hoisting or lowering in connection with the processes shall have been tested, and shall be periodically examined. All such chains shall be effectually softened by anneaing or firing when necessary, and all half-inch or smaller chains in general use shall be so annealed or fired once in every six months. If the chains are part of the outfit carried by a seagoing ship it shall be a suf- ficient compliance with this regulation as regards softening by annealing or firing of half-inch or smaller chains, that no such chains shall be used unless they have been so annealed or fired within six months preceding. As regards chains, the safe-loads indicated by the test the date of last an- nealing, and any other particulars prescribed by the secretary of state, shall be entered in a register which shall be kept on the premises, unless some other place has been approved in writing by the chief inspector. 10. All motors, cog-wheels, chain and friction gearing, shafting and live elec- tric conductors used in the processes shall (unless it can be shown that by their position and construction they are equally safe to every person employed as they would be if securely fenced) be securely fenced so far as is practicable without impeding the safe working of the ship without infringing any requirement of the board of trade. 11. The lever controlling the link motion reversing gear of a crane or winch used in the processes shall be provided with a suitable spring or other locking arrangement. 12. Every shore crane used in the processes shall have the safe-load plainly marked upon it, and if so constructed that the jib may be raised or lowered i66 either shall have attached to it an automatic indicator of safe-loads or shall have marked upon it a table showing the safe-loads at the corresponding inclina- tions of the jib. 13. The driver's platform on every crane or tip driven by mechanical power and used in the processes shall be securely fenced, and shall be provided with safe means of access. 14. Adequate measures shall be taken to prevent exhaust steam from any crane or which obscuring any part of the decks, gangways, wharf, or quay, where any person is employed. 15. No machinery or gear used in the processes, other than a crane, shall be loaded beyond the safe-load; nor a crane, unless secured with the written per- mission of the owner by plates or chains or otherwise. No load shall be left suspended from a crane, winch, or other machine unless there is a competent person actually in charge of the machine while the load is so left. 16. A boy under 16 shall not be employed as driver of a crane or winch, or to give signals to a driver, or to attend to cargo falls on winch-ends or winch- bodies. 17. Where in connection with the processes goods are placed on a wharf or quay other than a wharf or quay on a shallow canal: (a) A clear passage leading to the means of access to the ship required by Regulation 4 shall be maintained on the wharf or quay; and (b) If any space is left along the edge of the wharf or quay, it shall be at least three feet wide and clear of all obstructions other than fixed structures, plant and appliances in use. 18. No deck-stage or cargo-stage shall be used in the processes unless it is substantially and firmly constructed, and adequately supported, and, where neces- sary, securely fastened. No truck shall be used for carrying cargo between ship and shore on a stage so steep as to be unsafe. Any stage .which is slippery shall be made safe by the use of sand or otherwise. 19. Where there is more than one hatchway, if the hatchway of a hold ex- ceeding seven feet six inches in depth measured from the top of the coamings to the bottom of the hold is not in use and the coamings are less than two feet six inches in height, shall either be fenced to a height of three feet, or be securely covered. Provided that this regulation shall not apply during meal-times or other temporary interruptions of work during the period of employment. And provided that until the 1st of January, 1908, the fencing may be the best the circumstances will allow without making structural alteration. Hatch coverings shall not be used in connection with the processes in the construction of deck or cargo stages, or for any other purpose which may expose them to damage. 20. No cargo shall be loaded by a fall or sling at any intermediate deck unless a secure landing platform has been placed across the hatchway at that deck. 21. No person shall, unless duly authorized, or in case of necessity, remove or interfere with any fencing, gangway, gear, ladder, life-saving means or appliances, lights, marks, stages, or other things whatsoever, required by these regulations to be provided. 22. The fencing required by Regulation 1 shall not be removed except to the extent and for the period reasonably necessary for carrying on the work of the dock or ship, or for repairing any fencing. If removed it shall be restored forth- with at the end of that period by the persons engaged in the work that neces- sitated its removal. 23. No employer of persons in the processes shall allow machinery or gear K>7 to be used by such persons in the processes that does not comply with Part III of these regulations. 24. If the persons whose duly it is to comply with Regulations 4, 5, and 7 fail so to do, then it shall also be the duty of the employers of the perfoni I mployed for whose use the means of access and the lights arc required to comply with the said regulation within the shortest time reasonably practicable aff-i failure. 25. The certificate of the ship's register and any other certificate or register referred to in these regulations shall be produced by the person in charge thereof on the application of any of II. M. inspectors of factories. A. Akers-Douglas, One of His Majesty's Principal Secretaries of State. Home Office, Whitehall, 24th October, 1904. Factory Engines and Cars. Whereas the use of locomotives, wagons, and other rolling stock on lines of rail or sidings in any factory or workshop or any place to which the provisions of section 79 of the Factory and Workshop Act, 1901, are applied by that act or on lines of rail or sidings used in connection with any factory, or workshop or any place as aforesaid, and not being part of a railway within the meaning of the Railway Employment (preventions of accidents) Acts, 1900, has been certified in pursuance of the said section to be dangerous : I hereby in pursuance of the powers conferred upon me by that act make the following regulations and direct that they shall apply to all places before mentioned. These regulations shall come into force on the 1st day of January, 1907, except Regulations 1, 2, and 22, which shall come into force on the 1st day of January, 1908. Subject to the exemptions below, it shall be the duty of — (i) The occupier of any factory or workshop and any place to which any of the provisions of the Factory and Workshop Act, 1901, are applied, and («) The occupier of any line of rails or sidings used in connection with a factory or workshop, or with any place to which any of the provisions of the Factory and Workshop Act, 190 1, are applied, to comply with Part I of these regulations. And it shall be the duty of every person who by himself, his agents or work- men, carries on any of the operations to which these regulations apply, and of all agents, workmen and persons employed to -comply with Part II of these regulations. And it shall be the duty of every person who by himself, his agents, or work- men, carries on any of the operations to which these regulations apply, to comply with Part III of these regulations. In these regulations : Line of rails means a line of rails or sidings for the use of locomotives or wagons except such lines as are used exclusively for (a) a gantry crane or trav- eling crane, or (b) any charging machine or other apparatus or vehicle used exclusively in or about any actual process of manufacture. Wagon includes any wheeled vehicle or non-self-moving crane on a line of rails. Locomotive includes any wheeled motor on a line of rails used for the move- ment of wagons and any self-moving crane. Gantry means an elevated structure of wood, masonry, or metal, exceeding 6 feet in height and used for loading or unloading, which carries a line of rails, whereon wagons are worked by mechanical power. Nothing in these regulations shall apply to : (a) A line of rails of less than 3 feet gauge, and locomotives and wagons used thereon. (b) A line of rails not worked by mechanical power. (c) A line of rails inside a railway goods warehouse. (d) A line of rails forming part of a mine within the meaning of the Coal Mines Regulation Act, 1887, or of a quarry within the meaning of the Quarries Act, 1894, not being a line of rails within or used solely in connection with any 1 68 factory or workshop not incidental to the maintenance or working of the mine or quarry or to the carrying on of the business thereof. (e) Pit banks of mines to which the Metalliferous Mines Regulation Act, 1872, applies, and private lines of rails used in connection therewith. (/) Lines of rails used in connection with factories or workshops, so far as they are outside the factory or workship premises, and used for running pur- poses only. (g) Wagons not moved by mechanical power. (/1) Buildings in course of construction. (/) Explosive factories or workshops within the meaning of the Explosives Act, 1875. (/) All lines and sidings on or used in connection with docks, wharves and quays not forming part of a factory or workshop as defined in section 149 of the Factory and Workshop Act, 1901. (k) Wagon or locomotive building or repairing shops, and all lines and sidings used in connection with such shops if such shops are in the occupation of a rail- way company within the meaning of the Regulation of Railways Act, 1871. (1) Depots or car-sheds being parts of tramways or light railway undertak- ings authorized by Parliament, and used for the storage, cleaning, inspection or repair of tramway cars or light railway cars. 1. Point rods and signal wires in such a position as to be a source of danger to persons employed shall be sufficiently covered or otherwise guarded. 2. Ground levers working points shall be so placed that men working them are clear of adjacent lines, and shall be placed in a position parallel to the ad- jacent lines, or in such other position, and be of such form as to cause as little obstruction as possible to persons employed. 3. Lines of rails and points shall be periodically examined and kept in efficient order, having regard to the nature of the traffic. 4. Every gantry shall be properly constructed and kept in proper repair. It shall have a properly fixed structure to act as a stop-block at any terminal point; and at every part where persons employed have to work or pass on foot there shall be a suitable footway, and if such footway is provided between a line of rails and the edge of the gantry the same shall so far as is reasonably practi- cable, having regard to the traffic and working, be securely fenced at such a dis- tance from the line of rails as to afford a reasonably sufficient space for such persons to pass in safety between the fence and a locomotive, wagon or load on the line of rails. 5. Coupling poles or other suitable mechanical appliances shall be provided where required for the purpose of Regulation 11. 6. Proper sprags and scrotches when required shall be provided for the use of persons in charge of the movement of wagons. 7. Where during the period between one hour after sunset and one hour before sunrise, or in foggy weather, shunting or any operations likely to cause danger to persons employed are frequently carried on, efficient lighting shall be provided either by hand lamps or stationary lights as the case may require at all points where necessary for the safety of such persons. 8. The mechanism of a capstan worked by power and used for the purpose of traction of wagons on a line of rails shall be maintained in efficient condition and if operated by a treadle such treadle shall be tested daily before use. PART II. 9. When materials are placed within 3 feet of a line of rails and persons em- ployed are exposed to risk of injury from traffic by having to pass on foot over them or between them and the line such material shall, as far as reasonably practicable, be so placed as not to endanger such persons, and there shall be ade- quate recesses at intervals of not more than 20 yards where the materials exceed that length. . 10 No person shall cross a line of rails by crawling or passing underneath a train or wagons thereon where there may be a risk of danger from traffic. iGg 11. Locomotives or wagons shall wherever it is reasonably practicable without structural alterations he coupled or uncoupled only by meant of a coupling pole or other suitable mechanical appliance, except where the construction of loco- motives or wagons is such that coupling or uncoupling ran be Safely and con- veniently performed without any part of a man's body being within the between the ends or buffers of one locomotive or wagon and another. 12. Sprags and scratches shall be used as and when they are required 13. Wagons shall not be moved or be allowed to be moved on a line of rail . by means of a prop or pole, or by means of towing by a rope fir chain attached to a locomotive or wagon moving on an adjacent line of rails when other rea- sonably practicable means can be adopted; provided that this shall not apply to the movement of ladles containing hot material on a line of rails in front of and adjacent to a furnace. In no case shall props be used for the above purpose unless made of iron, steel, or strong timber, hooped with iron, to prevent splitting. 14. Where a locomotive pushes more than one wagon, and risk of injury may thereby be caused to persons employed, a man shall, wherever it is safe and rea- sonably practicable, accompany or precede the front wagon or other efficient means shall be taken to obviate such risk. Provided that this regulation shall not apply to the following : (a) Fly shunting. (b) Movement of wagons used for conveyance of molten or hot material or other dangerous substance. 15. No person shall be upon the buffer of a locomotive or wagon in motion unless there is a secure handhold and shall not stand thereon unless there is also a secure footplace ; nor shall any person ride on a locomotive or wagon by means of a coupling pole or other like appliance. 16. No locomotive or wagon shall be moved on a line of rails until warning has been given by the person in charge to persons employed whose safety is likely to be endangered. Provided that this regulation shall not apply to a self-moving crane within a building or to a charging machine or other vehicle so long as it is used in or about any actual process of manufacture. 17. Where persons employed have to pass on foot or work, no locomotive or wagon shall be moved on a line of rails during the period between one hour after sunset and one hour before sunrise, or in foggy weather, unless the approaching end, wherever it is safe and reasonably practicable, is distinguished by a suitable light or accompanied by a man with a lamp. Provided that this regulation shall not apply to the movement of locomotives or wagons within any area which is efficiently lighted by stationary lights. 18. The driver in charge of a locomotive, or a man preceding it on foot, shall give an efficient sound signal as a warning on approaching any level crossing over a line of rails .regularly used by persons employed, or any curve where sight is intercepted, or any other point of danger to persons employed. 19. A danger signal shall be exhibited at or near the ends of any wagon or train of wagons undergoing repair wherever persons employed are liable to be endangered by an approaching locomotive or wagon. 20. (a) The space immediately around such capstan as mentioned in Regula- tion 8 shall be kept clear of all obstruction. (b) Such capstan shall not be set in motion until signals have been ex- changed between the man in charge of the capstan and the man working the rope or chain attached to it. (c) No person under 18 years of age shall work such capstan. 21. No person under the age of 18 shall be employed as a locomotive driver, and no person under the age of 16 shall be employed as a shunter. 22. All glass tubes or water gauges on locomotives or stationary boilers used for the movement of wagons shall be adequately protected by a covering or guard. H. J. Gladstone, One of His Majesty's Principal Secretaries of State. Home Office, Whitehall, 24th August, 1906. INDEX Page. Ablutions 107 Abortions 23 Accidents and injuries 61 Accidents, coal-mine 56 Accidents in mills 26-27 Accidents, industrial 14, 125 Accidents, mining 57 Accidents, prevention of 82 Accidents, railway 60 Accident statistics 55-61-62 Acid, hydrochloric 41 Acid, nitric 42 Acid, sulphuric 40, 42 African boxwood 22 Air space 16, 74 Alcohol habit 15, 71 Alcohol, wood 46, 47, 48 Alkali works 41 Ammonia 42 Aniline dyes 46 Aniline vapor, poisoning by 47, 48 Animal dust 28 Anthrax infection 30, 125 Antimony 142 Arsenic 39, 142, 143 Arsenical dust 39 Arsenical fumes 50 Arsenical poisoning 125, 126 Artificial light 81 Bakers 22, 52 Ba rometers 50 Baths and bathing 107 Beds and bedding 111 Bed hours 112 Beet-sugar industry 52 Bell metal 144 Belting 55 Benzine 44 Bisulphide of Carbon 149 Black lung 58 Blacksmiths 52 Bleachers 13, 43 Bleaching establishments 43 Blindness 56 Body, care of no Boiler explosions 55 Boiler makers' deafness 54 Boils 106 Bone 28-29 Bookbinders 13 Bottling aerated water 162 Boots 1 10 Bowels 114 Boxwood, African 22 Brakemen 61 Pact I'.rass foundry 21, 144 Brass founders 13 Brass founders' ague \<> Brick making 126 Bristles, hogs' 29 Bronchitis 58 Bronze 144 Bronzing 50 Bronzing powders 20 Bromine 43 Brush making 29 Brushes, wire 2\ Byssinosis 25 Cabinet makers 22 Caisson disease 53 Candle factories 63 Carbon 149 Carbonic-acid gas 45 Carbon dioxide 45 Carbon disulphide 45 Carbon monoxide 45 Cars 167 Care of special organs or parts of the body H3 Carelessness 55 Carpet factories 27 Cats 105 Catarrh, bronchial 41 Carpenters 22 Celluloid industry 28 Charcoal men 22 Chemical works 145 Child labor 64, 66 Chimney sweeps 22 China manufacture, decoration. scouring *34 Chlorine gas 43 Choke damp 58 Chrome pigments 49 Cigar and cigarette factories 23 Circular saws 55 Clothing 108 Clothing, cause of disease 109 Coal gas 45 Coal-mine accidents 56 Coal miners 22 Coal oil stoves 104 Coca-bola SB Cold S* Colors 34. 143 Compensation 138. 139 Compositors 13 Consumption 17. 26. 58. 71 Colic, lead 32. uS. 119 Constipation 114 172 Page. Cooks 52 Cooking 100 Cooking utensils 104 Compressed air '. 53 Copper 46 Coppersmiths 13 Corundum 22 Cotton dust 25 Cotton and flax textiles 23 Cubic air space 74 Curlers 24 Cutters, file 19 Cutlery 19 Dampness 52 Dangerous industries 125, 127 Debility 25 Deafness 54 Defective vision 73 Delta metal 144 Derby hats 28 Digestive disorders 17 Di-nitro-compounds 46, 148 Diseases in factories and workshops. 125 Disinfection, spittoons 122 Docks 163 Dogs 105 Down quilts 1 1 1 Dreams 113 Dressing room 131 Dust, animal 17, 28 Dust, arsenical 39 Dust, bone 28 Dust, cotton 25 Dust, flax 25 Dust, horn 28 Dust, household 103 Dust, infectious 18, 26 Dust, irritating 16 Dust, lead 31 Dust, mercurial 50 Dust, metallic 17, 18 Dust, mica 20 Dust, mineral 17, 18 Dust, mixed 17, 125 Dust, vegetable 17 Dyeing and cleansing 46 Dyes, aniline 46 Dyestuff s 46 Ear, care of 115 Earthenware works 126, 134 Eating houses 100 Eating utensils 104 Eczema 49 Electric accumulators 140 Electric batteries 5° Electrotypers 13 Emergency room 125 Emery and emery wheels 21, 22 Employment of women and children. 64 Enameling 143 Engravers 54 Engines 167 Page. Eyes, care of 115 Hxplosives 13. 47, 52, 148 Expositions devoted to industrial and social betterment 85 Factories, carpet and rug 27 Factories, cigars and cigarette 23 Factories, felt hat 29 Factory and working act, Eng- land 125, 5 Fan 125 Fatigue 25, 72 Feather beds Ill Federal Government 86 Felt hats 28, 29, 153 Felt establishments 5° Fertilizer making 63 File cutters 13, 19, 32 File cutting 160 Finishers of plates 1 16 Firemen 13, 22, 52 Fire damp 58 Flat feet 25, 65 Flax 23, 25 Fly, cotton 25 Food for working classes 100 Footwear no Founders 35 Founders, brass 49 Foundries, brass 21 Foundries, iron 21 Foundries, stove 21 Foundries, type 117 Fumes, arsenical 50 Fumes, lead 33 Fumes, poisonous 40 Fur 29 Galling 106 Galvanizing works 4 1 Gas 125 Gas, carbonic-acid 45 Gas, chlorine 43 Gasoline 40, 104 Gas stoves 104 Gases, poisonous 4° Gas works, employees 13 Gem finishers 20 German printing houses. 37 Glass 126 Glazing 125 Glue factories 63 Government printing office 116 Grain elevators and threshers 22 Grinders, metal 19. I2 5 Gun metal 144 Gunny cloth 27 Hair, curled 29, 30 Hair sorting 155 Head dress 109 Heat 52 Hemp 27 Hide depots 63 Hides 154 '7 '3 Pagk. Hogs' bristles 29 Home 102 Home factories 73 Homes for wage-earners 07 Horn 29 I louse cleaning km Household dust 103 Household pets 105 Humidity of the air 79 Hygiene, industrial 9 1 [ygiene, personal 101 Hypochondry 114 Indoor occupations 15 Industrial accidents 14 Industrial betterment 85, 94 Industrial diseases 14 Industrial insurance 87 Industrial phthisis 25 Infant mortality in relation to the occupation of women 68 Infectious dust 26, 29 Illumination 73 India rubber 149 Injuries 61 Insanitary houses and overcrowd- ing 97 Insects 104 Inspection of factories 129 Insurance, industrial 87 Invalid and old age pensions 89 Iodine 43 Iron and iron foundries 21, 46 Irritating dust. 16 Ivory 29 Joiners 22 Jute 27 Kitchens 100 Kitchen utensils 104 Knock-knee 54. 65 Labor legislation 10 Lead colic 32, 118, 119 Lead dust 31 Lead fumes 33 Lead pipe 33 Lead poisoning 32, 119, 125, 126 Lead smelters 32 Lead works 129 to 133 Leaky downspouts 102 Leaky roofs 102 Lighting 80 Linen spinners 24 Lithograhphers 54 Lodging houses and sleeping quarters 85 Machinery supplies 20 Malaria 105 Manganese 49 Manilla mixture 144 Masons 56 Match workers 13 Matches, manufacture of.... 51, 126. 150 Measures for the protection of Pax* w^kc earnen 72 Mercury Mercury, cyanide of 2H Mercury dust 50 Mercurial poisoning 125 Metallic dust iH Metal grinden ig Metal luppliei Metal workers 56 Miners 56 Mica dust 20 Mill hands 24 Millers 22 Mills, shoddy 28 Mill towns 26 Mills, woolen 23 Millstone cutting 20 Miners 56 Mining accidents 57 Mineral dust 18 Mirror makers 50, 126 Miscarriages 50 Morbidity and mortality of wage- earners 10, 12 Morbidity and mortality of printers. 35 Mosquitoes 105 Mules, self-acting 162 Naphtha 46 Neck 109 Needle polishers 19 Nitrobenzol 46 Nondusty trades workers 17 Nose, care of 115 Occupations and mortality 10, 13 Occupations, dangerous, English regulation of 125-169 Occupations, indoor 15 Occupations involving constrained attitudes 54 Occupations involving exposure to infective matter in dust 29 Occupations involving exposure to irritating dust 16 Occupations involving exposure to machinery 55 Occupations involving over exercise of parts of the body 54 Occupations involving the inhalation of organic gases and vapors 63 Occupation of women, relation to infant mortality 68 Offensive trades 63 Organic gases and vapors, inhalation of 63 Overcrowding 97 Overwork 25, 72 Paints 34. 143 Paper industry 30 Paris green 34 Parrots 105 Patent leather industry 47 Pensions, invalid and old age 89 174 Page. Petroleum 44 Phosphor bronze 144 Phosphorus 51, 150 Phosphorous, white and red 51 Phosphorus poisoning 125 Photometer 82 Pigeons 105 Pigments, chrome 49 Pillows, feather Ill Pimples 106 Plumbers' supplies 33 Pneumonia 17 "Pneumonie cotonneuse" 25 Poisoning, lead 32, 119 Poisonous gases 40 Polishers 19, 20, 49, 125 Polisher's itch 49 Porters 61 Potassium 146 Potters 13 Pottery industry 32 Poultry 105 Prevention of accidents 82 Printers 35 Privies 83 Propulsion and aspiration system... 76 Prussian blue 34 Public duties 95 Public speakers 54 Quarrymen 20 Quinine 49 Rag industry 29, 30 Rag sorters' disease 3° Railway service 59 Railway accidents 60 Red lead factory 33 Reelers 24 Regulation of dangerous trades, England 125 to 169 Regulations controlling printing houses 37 Rentals 97 Respirators 5 2 , I01 Roosevelt, President 86 Rubber factory operatives 13 Rubber industry 47 Rug factories 27 Safety devices 51, 101 Sal ammoniac 41 Sandpaper 22 Sanitation of workshops and quar- ters for employees 73 Sanitary conveniences 83 Scheele's green 39 Sewer air 63 Sheep dip 39 Shell 29 Shoes no Shoemakers 54 Shoddy mills 28 Silk 29 Silvering of mirrors 126 Page. Singers 54 Skin, care of 106 Skins 154 Slate cutting 20 Sleep in Sleeping quarters 85 Smelters, lead 32 Smelters, zinc 32 Smoking 32 Soap factories 63 Social conditions 96 Social betterment 97 Sodium 146 Soldiers' iiome, Washington 93 Special measures for the prevention of tuberculosis among wage- earners 71 Spinners 24 Spitting habit 23 Spittoons, disinfection 122 Steel foundries 21 Stereotyping 116 Stokers 52 Stonecutters 13, 19, 20 Stoves, coal oil or gas 104 Stove foundries 21 Sugar of lead 31 Sulphur dioxide 40 Sunstroke 5 2 Swimming baths 107 Tailors 54 Tanneries 63 Tea tasters 55 Teeth, care of 113 Temperature 78, 104 Tenement factories and houses.... 127 Textiles, flax 23 Textile mills 26 Theine intoxication 55 Thermometers 50 Threshers, grain 20, 23 Tiles 126 Tinning 143 Tobacco 23 Tobacco testers 55 Tow spinning 158 Track walkers 59 Tuberculosis 17, 26, 58, 71 Tuberculosis, prevention of 71 Turkish baths 107 Turpentine 44 Type foundries 116, 117 Typesetters 35 Unhealthy industries 125 Uterine derangements 25 Uterine displacements 25 Urinals 83 Varicose veins 54 Varnishes 34 Ventilation 75 Wage-earners, morbidity and mor- tality of 12 '75 Page. Wage-earners, protection of 71, 72 Washington Sanitary Improvement Company 99 Waste products 72 Watchmakers 54 Water closets 83 Weavers 24, 54, 56 Weaving 158 Wet-spinning 126 Welfare of employees 93, 101 Wharves 163 Wheels, emery 21 White lead workers 13, 126, 129 Winders 24 Wind instruments 54 Wire brushes 21 I'a'.k Wire cloth 34 Wire making 34 Women and children, employment of 64 Wood, hard 22 Wood, soft 22 Wood alcohol 46, 48 "Wool sorters' " disease 30 Wool sorting 155 Woolen mills 23 Workshop act, England 125 Workshop and quarters, sanitation of 73 Yellow fever 105 Zinc smelters 32 7- 3 y^t &U>v/!&A/ \