V. INFANT MORTALITY AND FACTORY LABOUR…

V. INFANT MORTALITY AND FACTORY LABOUR

I

“What is not good for the bee-hive cannot be good for the bee.” A better appreciation of this truth and there had been less cause for this chapter. But in so grave a degree is a demonstrated danger to the race tolerated in the pursuit of an imagined profit to the individual, that it cannot be impertinent to recall the general truth and to point its specific application.

That there is danger to the race in the engagement in factory life of the mothers of young children, should be beyond challenge: always danger to the child, often danger to the mother; and sacrifice of infant life, failure of infant promise follow, have followed, and must follow, as surely as leaves fall to frost. Statistics abound, but for the most part they have received their lot of Bluebook burial; and the purpose of this article is, in the main, to rescue from the obscurity of the past its array of facts and its store of warnings. Upon the statistical evidence of the present there is less need to dwell. Dr Reid, in his admirable chapter, has dealt fully with the striking results of an inquiry conducted by him as Medical Officer to the Staffordshire County Council; and an inquiry instituted throughout England, upon similar lines, by the Parliamentary Bills Committee of the British Medical Association, supported, Dr Reid tells us, “in a remarkable way the conclusions drawn from the Staffordshire figures.” These are the Staffordshire figures:--

_Deaths of Children under 1 year in Three Classes of Artisan Towns in Staffordshire per 1000 births._

CLASS I. CLASS II. CLASS III. Many Women Fewer Women Practically no Women engaged in work. engaged in work. engaged in work. 10 years (1881–90) 195 166 152 9 years (1891–99) 210 177 168[27]

At all moments they are figures to command concern, at this moment they compel alarm. On the one hand is the infant death-rate steadily rising, on the other the birth-rate steadily falling;[28] and to the rising death-rate maternal neglect gives impetus, while the State inattentively takes note. But though statistical speech is eloquent of death, it says nothing of withering injury to life; nothing of injury to the mother who, herself affected in health, produces less fitting children; nothing of those children who escape death to endure life, crippled in body and in mind, drugged and starved in infancy, neglected in childhood. What dare we ask of their womanhood and their manhood? What service of citizenship have we any right to demand, any reason to expect? We must seek our answer from within our reformatories and our asylums, from our hospitals, our workhouses, and our prisons. For the feeble in body and dwarfed in mind there is no room in the struggle for industrial supremacy. Their drifting place is among criminals, in the lowest ranks of industry, or in the homes of charity.

Every deadly industry has its octogenarian; and so, too, under this system there are those who escape, or escape at least its greatest evils of physical and mental disability. For the girl-children full escape seems impossible. Victims in their ignorance of home, they become vehicles to perpetuate the system; without knowledge of the sacred, the helpful, even the elementary elements of home life, they in their turn, in their own married life, seek mill employment as did their mothers before them. It is, in fact, the only occupation they know. Baking, washing, sewing, are dead arts; and in these children of mothers, “to a grievous extent denaturalised towards their offspring,”[29] the deepest forces of nature seem asleep. So from generation to generation the service of the mother to her child is entrusted to a stranger, whose introduction as substitute housewife, substitute mother is not without its cost. The net gain is sometimes in money a few shillings: in influence and training there is always loss; even in money sometimes loss. In evidence given to the Royal Labour Commission, a Yorkshire employer quotes a case “in which the woman drew 10s. a-week in wages, and paid 12s. a-week for the care of her home.”[30] The case may indeed be exceptional, but an abundance of other cases may be found where the actual gain in money is but slight. The companion to this picture of the mother in the factory and the paid stranger in the home, is that of the mother drudge who, neglecting her duty to her children, placing it perhaps in pathetically inadequate child hands, yet tries to fulfil it to her home. She may have worked in the factory from six in the morning to six or eight in the evening; but worker in the factory, she is worker too in the home. For her the day is never done, and through her youth of unending labour she is hastening to old age. There are advocates of such freedom to labour who can be convinced of hardship to the mother, who yet claim benefit for the child. Better far, they urge, the mother’s laboured addition to the family fund than scanty meals; home care and influence are necessary enough, but without bread what are they?

To this argument the answer comes from homes bread-starved during the cotton famine in Lancashire, during the great depression of trade in Coventry, and during the siege of Paris. “During the Lancashire cotton famine, while privation increased the actual death-rate, the infant death-rate was greatly lessened owing to mothers being compelled to suckle their infants. During the siege of Paris also, while the general mortality was doubled, the infant mortality fell 40 per cent. from similar causes.”[31] And, writing of the effect in Coventry of the prostration of trade in 1861, the Registrar-General says:--“The care of the mothers of Coventry has, it would seem, counteracted some of the effects of privation, so that neglect of their homes by mothers at work in factories is apparently more fatal than starvation.”

In the comparative figures given by the Registrar-General for the ten years (1859–68), the reduced infant mortality during the three cotton famine years (1862–64) is strikingly shown.

_Deaths of Infants under 1 year of age per 1000 Births in Lancashire, and in the whole of England and Wales, 1859–68._

Year. Lancashire. England and Wales.

1859 176 153 1860 169 148 1861 184 153 1862 168 142 1863 171 149 1864 174 153 1865 189 160 1866 200 160 1867 185 153 1868 187 155

The Registrar of Little Bolton held that the decrease of deaths was mainly due to a greater amount of domestic superintendence, and other registrars united in similar conclusions. The slight rise in 1863 and 1864 was apparently due to the prevalence of smallpox, scarlatina, typhus, and measles, caused by overcrowding in workhouses and bad sanitary conditions.

Comparison between privation and maternal care on the one hand, and good cheer and maternal neglect on the other, to the advantage of the meaner diet and the greater care must, as the Registrar-General admits, be within limits. Under the stress of absolute starvation, no mother could provide nourishment for her child. But the obviousness of the limitation cannot diminish the significance of facts, and evidence, official evidence of convincing weight and appealing eloquence is, if we look for it, at our hand. It is easy to realise in its light, why the mother, even though poorly fed herself, is a better mother than the mother who earns a certain keep-money for her child.

Sir John Simon,[32] writing in 1897 of the inquiries conducted between 1859 and 1872 by the Medical Department of the Privy Council, of which he was Medical Officer, says of one:--“In addition to showing on a very large scale those sanitary wrongs of certain sorts of industry, we had also shown as an industrial influence of very wide operation, that in proportion as adult women were taking part in factory labour or in agriculture, the mortality of their infants rapidly increased; that in various registration districts, which had such employment in them, the district death-rate of infants under one year of age had been from two and a quarter to three times as high as in our standard districts; and that in some of the districts more than a few of the infants were dying of ill-treatment which was almost murderous.” Considering the subject in greater detail, in his fourth report to the Privy Council, he recalls the report[33] made to the General Board of Health in 1858, in which he drew attention to the fact that in different districts of England there were enormous differences of infantile mortality: “Such differences, that children in some districts die at perhaps four or five times the rate of children in other districts.” These wide differences of death-rate he attributed “to the varying prevalence of two local causes:--first, to differences of degree in common sanitary defects of residence; ... and secondly, to occupational differences among the inhabitants; there being certain large towns where women are greatly engaged in branches of industry away from home; where, consequently, the home is ill kept; where the children are little looked after; and where infants who should be at the breast are improperly fed or starved, or have their cries of hunger and distress quieted by those various fatal opiates which are in such request at the centres of our manufacturing industry.” An inquiry was conducted by Dr Greenhow into the second of these influences, and commenting upon his report, Sir John Simon says: “It gives a very sad picture of suffering and demoralisation, caused by the present circumstances of female employment in factories. It corroborates very exactly the opinion above expressed as to the probable causes of the high mortality of infants in places of female factory occupation. And it shows that, while the infants perish under the neglect and mismanagement which their mothers’ occupation implies, the mothers become to a grievous extent denaturalised towards their offspring.”

The following quotations, Sir John Simon continues, tell the main facts of the case:--“Factory women soon return to labour after their confinement. The longest time mentioned as the average period of their absence from work in consequence of child-bearing was five or six weeks; many women among the highest class of operatives in Birmingham acknowledged to having generally returned to work at the expiration of a month.[34]... Mothers employed in factories are, save during the dinner-hours, absent from home all day long, and the care of their infants during their absence is entrusted either to young children, to hired nurse-girls, sometimes not more than eight or ten years of age, or perhaps more commonly to elderly women, who eke out a livelihood by taking infants to nurse. Young girls, aged seven or eight years, are frequently removed from school for the purpose of taking charge of younger children while the mother is absent at work, and are sometimes said to return, on the death of the child, evidently rather pleased that this event has released them from their toil.... Pap, made of bread and water, and sweetened with sugar or treacle, is the sort of nourishment usually given during the mother’s absence, even to infants of a very tender age; and in several instances, little children not more than six or seven years old were seen preparing and feeding babies with this food, which in such cases consisted only of lumps of bread floating in sweetened water.... Illness is the natural consequence of this unnatural mode of feeding infants.... Children who are healthy at birth rapidly dwindle under this system of mismanagement, fall into bad health, and become uneasy, restless, and fractious. To remedy the illness caused by mismanagement various domestic medicines are administered, more particularly some kind of opiate such as Godfrey’s cordial or laudanum. Wine, gin, peppermint, and other stimulants are often given, for the purpose, as alleged, of relieving flatulence, the actual effect being, however, rather to stupify the child. The quantity of opiates sold for the purpose of being administered to infants in some of the manufacturing towns is very large.... Indeed, there seems to be no doubt that the habitual administering of opiates to infants must be included among the causes of a high infantile mortality in certain manufacturing towns, not only on account of an overdose being given, but also because infants kept in a state of continual narcotism will be thereby rendered disinclined for food, and be but imperfectly nourished.... Parents who thus entrust the management of their children so largely to strangers become more or less careless and indifferent about them, and as many of these children die, the mothers become familiarised with the fact, and speak of the deaths of their children with a degree of nonchalance rarely met with among women who devote themselves mainly to the care of their offspring.... Abundant proof of the large mortality among the children of female factory operatives was obtained during the inquiry. An operative of the better class in Birmingham reported that he collects money for the expenses attendant on the deaths of children among the workers in a factory where 150 women were employed, and that he believed ten out of every twelve children born to the married women in this factory died within a few months after birth. Many married women were questioned, as opportunity served, in the several factories visited regarding their families, the number of children they had borne, the number that survived, and the manner in which they were brought up. The evidence of these women tallied exactly with that of other persons.... It was frequently found that two-thirds or three-fourths of the children borne to these women had died in infancy.” In his report, which appears in the Appendix,[35] Dr Greenhow continues: “And on the other hand, it was remarkable how, in other instances, the majority of the children were reared when the mothers did not work in factories, or discontinued doing so whilst nursing, or when the infant’s supplementary food consisted partly or chiefly of milk.” In the same report Dr Greenhow states that “all the medical men who gave evidence on the subject of the present inquiry, besides several clergymen, ladies who are accustomed to visit the poorer classes at their dwellings, scripture readers, relieving officers, and other persons who have paid attention to the subject, unhesitatingly expressed an opinion that the system under which the mothers of young children are employed at factories and workshops away from home is a fruitful cause of infantile sickness and mortality.”

Among the most interesting figures in the report are those which relate to the sale of Godfrey’s cordial. It appears that in Coventry alone at least 12,000 doses weekly were administered, and “even a larger quantity of opiate, in proportion to the population, is said to be sold in Nottingham than in Coventry.” In conclusion, Dr Greenhow reports: “The results of the inquiry may be stated as follows:--

“1st. The infantile death-rate bears no definite relation to the general death-rate, but their comparative proportions to each other vary in different districts.

“2nd. The infantile death-rate bears the largest proportion to the general death-rate in districts where the infantile population is specially exposed to unwholesome influences, as in Coventry, Nottingham, and other manufacturing towns.

“3rd. The unwholesome influences to which infants are exposed in the manufacturing towns comprised in the present inquiry may be attributed mainly to the industrial employment of the married women, which leads them to consign the tendance of their infants at a very early age to young children or strangers.

“4th. That infants thus deprived of the mother’s care are habitually fed on diet ill adapted to their digestive powers, and are very frequently drugged with opiates, in order to allay the fractiousness arising from the illness induced by improper food.

“5th. That infants in manufacturing towns where women are much engaged in factory labour are likewise exposed to other causes of sickness, proceeding from the ignorance or carelessness of the mothers or nurses, such as deficiency of exercise, and exposure to inclement weather.”

There is constant reference in public inquiries to the excessive use of opiates. Mr Ernest Hart, giving evidence in 1871 before the Select Committee on the Protection of Infant Life, says:--

“... We wish also to take measures to prevent the habitual drugging of children in those day-nurseries. You will get evidence easily from the manufacturing districts that opiates are sold by gallons by druggists there. The sale of opiates for that purpose forms a very large part of the trade of many of the druggists in those districts.” Later, Dr Lyon Playfair (afterwards Lord Playfair), a member of the same Committee, in examining a witness, refers to “the evidence of three druggists in Deansgate, who state that they supply 1260 families per week with opiates,” and to the experience of “Mr Ransome, a distinguished surgeon who lived in Manchester, ... that out of the children who attended his dispensary, about one-half he found to be drugged with opiates.”

Mr Curgenven, another surgeon witness before the Committee, speaking of the high death-rate among insured children, says:--

“... They know that if they put their children out with their neighbours, as it is said, to be nursed, brought up by hand, while they are at work in the factories, there is very great chance that they will die, and therefore they calculate that the sum which they receive from the burial club will more than cover the expense of the burial. And the deaths amongst the children of the operatives in the manufacturing towns amount to about 40 to 56 per cent., because they are left by their mothers at an early age, when they are only a few weeks old, and are placed in the hands of women to be brought up. They are drugged frequently with Godfrey’s cordial and other opiates to keep them quiet. They are fed upon bread and water with very little milk, so that they are half-starved. The consequence is that more than half of them die.”

And again:--“... The infantile mortality has decreased so far as the mothers were enabled to remain at home to nurse their children. It is only when they are employed in the factories, away from their homes, leaving their children to be brought up by hand by their kind neighbours, that they die.”

Turning to another inquiry, we find Mr Foulkes, a certifying surgeon, giving evidence before the Factory and Workshops Acts Commission of 1875, and pleading for a prohibition upon the return of mothers to their employment within six months of their confinement. “... Many of the women are at work within a month after they are confined; the result is that the child is left at home, and it is invariably fed upon the same thing, bread, water, and sugar, and the children dwindle away, and that has a great deal to do with the infant mortality of the place. What is done with the children in this district generally when the mothers are at work? They are often left with the other children; there is no provision made, and they are very badly treated and sadly neglected....”

Before the same Commission, Mr Baker, first a surgeon in practice at Leeds and then joint chief of the Factory Department with Mr Redgrave, gives it as his experience that “very considerable mischief arises with women going to work, not only to the mother, but also to the child.” He is then asked by the Chairman Sir James Fergusson: “We may take it for granted that it is not theoretically desirable that women should go to daily work immediately after confinement, leaving the child all day to somebody else; but, practically speaking, do you think from your experience of this matter, that if Parliament interfered with it, it could be enforced with uniformity and without hardship?” And his answer is: “Yes, I think it might. I think that by the visitation of certifying surgeons it might be enforced decently, and delicately, and sufficiently, so as to make it very useful.”

One more reference to Sir John Simon shall almost close this array of quotations from buried reports. In this last instance the inquiry was conducted in agricultural districts:--

“The discovery that an enormous infantile mortality was prevailing in several purely agricultural districts, suggested at first sight that perhaps in these districts some third[36] sort of destructive influence was at work. The result of this new inquiry, however, has been to show that the monstrous infantine death-rate of the examined agricultural districts depends only on the fact that there has been introduced into those districts the influence which has already been recognised as enormously fatal to the infants of manufacturing populations--the influence of the employment of adult women. ‘The opinions’ (says Dr Hunter) ‘of about seventy medical practitioners, with those of other gentlemen acquainted with the condition of the poor, were obtained. With wonderful accord, the cause of the mortality was traced by nearly all these well-qualified witnesses to the bringing of the land under tillage--that is, to the cause which has banished malaria and has substituted a fertile though unsightly garden for the winter marshes and summer pastures of fifty or a hundred years ago. It was generally thought that the infants no longer received any injury from soil, climate, or malarious influences, but that a more fatal enemy had been introduced by the employment of the mothers in the field.’ On this agricultural employment of women there follow identically the same results as have already been traced to result from the employment of women in manufacture.”

This, then, is the finding of skilled inquirers, the teaching of half a century’s statistics: that, for the child, the employment of the mother in the field is “a more fatal enemy” than malaria; and her employment in the factory, “apparently more fatal than starvation.” And what is our answering record of effort? A pathetic capacity for inquiry. Not certainly because we lack facts, or because the need for action has passed; for, on the contrary, it becomes cumulatively more acute. In Dundee, for example, in 1881, 19.4 per cent. of married women were employed in its mills and factories; in 1891, 24 per cent. were so employed, and the infantile death-rate rises accordingly. In the following table, prepared by Dr Templeman, Dundee’s able medical officer of health, this death-rate can be seen for a period of twenty-eight years:--

Average General Death-rate of Infantile Death-rate. Children. Death-rate.

1860–69 30.4 per 1000 Not ascertained Not ascertained 1870–79 25 „ 81 per 1000 153 per 1000 births 1880–89 22.2 „ 63 „ 155 „ „ 1890–97 20.8 „ 68 „ 176 „ „

First among the causes Dr Templeman puts “Industrial Conditions:” first, too, this recognition should be in the conscience of the parent, in the conscience of the employer, in the conscience of the State. Of all who are responsible, the State has least acknowledged the responsibility. The examples may be rare, it is true, of parents who make sacrifices themselves that their homes and children may have benefit, but yet there are examples. The efforts of employers of labour may, too, be rare, but still they are appreciable, notably in Yorkshire; more frequent are the efforts of philanthropy: there is one effort by the State;[37] not to save the life of the child, for that admittedly it does not do, one effort, barely calculable in its result, to protect the health of the mother.

All credit to those who, singly as employers, or collectively as philanthropists, have endeavoured to save life and preserve efficiency for the nation. But such effort of necessity is ineffective. It can never be complete, and the abstention of a few mill owners in a district is sufficient to annul the effort of the majority. The helplessness of such a position was so strongly felt by one mill owner in Yorkshire, that his rule prohibiting the employment of married women was abandoned: “Other mills being open to married women, the rule failed to serve the purpose for which it had been designed--that of keeping the women at home.”[38]

The attempt of philanthropy to establish day nurseries, discouraging as it has been, would even in apparent success serve but as a prop to an evil system, as an anæsthetic to the manufacturer’s conscience. It can but alleviate, it cannot cure; and its condemnation many years ago, for the involved exposure of the infant to unsuitable hours and inclement weather, holds equal force to-day. Better than the drug-nursery, but bad in itself, for the most excellently managed crèche might well provoke the situation described by Dr Greenhow, in Coventry[39]:--“Women being obliged to attend at the factory at an early hour are always hurried in the morning, and may be seen on their way to the mills, hastening along the street with their children only half dressed, carrying the remainder of their clothes, and their food for the day, to be left with the person who has charge of the child during its mother’s absence; and this ofttimes on a cold winter’s morning in the midst of sleet or snow.”

Widows without children of earning age may, as part of their burden, be forced to imperil the welfare of their infants in one direction while they seek it in another. And here philanthropy has just scope, for, save in exceptional cases, the crèche is the only practicable form of aid to the mother. Better, then, this care of her infant than its abandonment to a child, itself a candidate for the nursery, or to the elderly woman who confesses unfitness for all other employments. But this is the smallest section of the whole. In its widest aspect it is not a question for the make-shift, though devoted, benevolence of philanthropy; it is a problem for the State in its responsibility to the nation. What are the terrors that lie in its handling? The dread of a barrier raised before the freedom of employment: the fear that the prohibition of employment within say six, or even three, months after childbirth might embarrass a large class in its endeavour to earn a living. But the freedom to labour is no sacred right when its exercise involves injury to others; it is not even so held when it clearly threatens injury to ourselves. The worker in a dangerous trade is suspended from employment on the verdict of the certifying surgeon during such period as he considers to be necessary: in certain departments in a white-lead factory the employment of women and girls is altogether prohibited. There is therefore no inviolate right. Is there in this case necessity? What is the motive-power which drives the mothers of young children into factories? Commonly, ignorance of home duties, and the consequent unattractiveness of the home; the companionship of factory life, where the companionship of children has no meaning; often, fashion; least often, true poverty. There is poverty in Glasgow and in Paisley, as in Dundee, but its cure is not felt to lie in the employment of mothers. The father accepts the obligation of breadwinner; he is ashamed that his wife should work outside his home. “If a Glasgow lad wearies o’ work, he must marry a Dundee lassie.” There poverty conjures excuse, and a man is not ashamed to claim his wife before her time in the hospital is over, that she may come out and earn his bread. Exceptional, it must be hoped, are such cases, but at least the system which breeds them is not, and what some towns claim as a necessity, others will not tolerate, in their rejection disproving the need.

Within the space of this chapter it has been impossible to consider arguments to which place would otherwise have properly been given. It is left only to suggest a comparison of the possible evils which lie in action, and the certain evils which have come of inaction. The principle of regulation is already accepted in our laws, and in the laws of other countries, as Miss Anderson’s deeply-interesting chapter shows; it but needs extension to render it effective. The State holds the scales: difficulties on the one side, not light it is true; but on the other, forces weighted already with accomplished evil, charged with greater evil to come: on the one side, the fancied interests of the individual; on the other, the deepest interests of the nation. “It cannot be too distinctly recognised,” says Sir John Simon, “that a high local mortality of children must almost necessarily denote a high local prevalence of those causes which determine the degeneration of the race.”

MAY TENNANT.

II

Although a steady decline has taken place in the general mortality of the country coincident with, and, no doubt, in the main, consequent upon sanitary progress, it cannot be said that the infant mortality has diminished in like proportion, and among the many factors which contribute to the maintenance of a lamentably high death-rate among infants, not the least important is improper feeding, the result of ignorance on the part of mothers. If by some means the simple fact could be brought home to mothers that milk, and preferably human milk, is the only permissible diet for infants, the natural instincts of motherhood would prevail in the majority of cases, and thousands of otherwise healthy infants who do not now survive the first few months of life would reach an age when greater license in diet is permissible, and the chances of living are immensely greater. But, in a humanitarian sense, the saving of life which would thus be effected is of small moment when compared with the mitigation of the pain and misery which infants now have to suffer, and which has to be borne, not only by those whom death ultimately relieves, but by the still larger number who manage to survive the ordeal, and who thus have to suffer for a longer period.

From inquiries made some years ago, Dr Hope of Liverpool came to the conclusion that among the artisan classes in that town upwards of 50 per cent. of infants during the first three months of life are entirely breast-fed, 35 per cent. are reared on other food in addition to breast-milk, and 15 per cent. are entirely artificially fed. Analysing upon this basis a large number of deaths from diarrhœa, he found that for every death attributed to that cause among entirely breast-fed infants under three months’ old, 15 occurred among the mixed class, and that for every death which occurred among the breast-fed and mixed class combined, 22 occurred among the entirely artificially fed class. He also found that among infants aged from three to six months, for every death from diarrhœa among the partially breast-fed, 6 occurred among the entirely artificially fed class. Other observers who have devoted attention to this matter bear out Dr Hope’s conclusions, and it is a well-known fact that in countries where artificial feeding of infants is largely practised, the mortality is very high compared with other countries where natural feeding prevails.

Now the practice as regards the feeding of infants varies in different districts according to circumstances which will presently be referred to, and no one can dispute the fact that, other things being equal, infants reared for the first few months entirely on breast-milk have a far better chance of survival than either of the other two classes. No doubt this is very largely due to the gross ignorance which prevails, especially among the artisan classes, as to the only permissible substitutes for breast-milk; but we must deal with circumstances as we find them, and, up to the present at any rate, our efforts to bring about a better order of things have proved unavailing. When we ultimately succeed, as we must do, in getting the teaching of elementary hygiene introduced as a compulsory subject in all elementary schools, the more rational feeding of future generations of infants must follow as a natural consequence, and then, even if the proportion of breast-fed infants is not increased, the difference in the death-rates among the different classes (entirely breast-fed, partially breast-fed, and entirely artificially fed) will be greatly lessened, for the artificial food administered will more nearly approach nature’s requirements.

From what has been said, it follows that if from any cause the proportion of entirely artificially fed infants in a district were abnormally large, in the absence of any counteracting influences the infantile death-rate of the district would compare unfavourably with that of other districts in which circumstances did not prevail which disturbed what may be called the normal grouping of the children according to the methods of feeding. If, for example, taking Dr Hope’s figures, instead of 15 per cent. only of the infants under three months being entirely artificially fed, the number, from disturbing causes, more nearly approached say 85 per cent., the remaining 15 per cent. only being either partly or entirely breast-fed, it would certainly be surprising if the effect were not apparent in a greatly-increased mortality among infants.

Some twelve years ago, when, in my capacity as County Medical Officer, I first had occasion, among other duties, to inquire into the mortality returns of the various districts in Staffordshire, I was greatly impressed by a very marked dissimilarity in the infant mortality of the two groups of populous artisan towns, one in the north and the other in the south of the county, a dissimilarity which I subsequently found could not be accounted for by any apparent difference in the sanitary surroundings of the northern and southern towns. In view of the fact, however, that, generally speaking, the trades carried on in the southern group of towns did not afford much employment for women, whereas in the northern group the conditions in this respect were different, it occurred to me that in this was to be found the explanation of the high infant mortality of the northern compared with the southern towns. In order to test the accuracy of this conclusion, with the help of the District Medical Officers of Health, and from information obtained from manufacturers regarding the proportion of married women workers, I classified the purely artisan towns in the county into three groups, and obtained the infant mortality figures for previous years, in order to allow of more reliable conclusions being drawn. Since then I have continued to record the figures according to the same plan annually, and I have now records covering a period of 20 years, and relating to artisan towns only, with a mean total population of about 529,000. One may fairly claim, allowing that the home conditions in the towns in question, in other respects, apart from the proportion of artificially-fed infants, are practically identical, that records from such a large population and for so long a period may legitimately be used for our purpose from a statistical point of view, provided care is exercised in the classification of the towns in accordance with the number of young married women workers employed away from home, and who are thus prevented from suckling their children.

In the classification of the towns it was found impossible to arrive at the actual number of married women workers, but one was able to divide them into three groups, as follows:--

(1) Many Married Women Workers. (2) A good number of Married Women Workers. (3) Practically no Married Women Workers.

Adopting this classification, the figures of infant mortality in the different groups of towns are set forth in the following table:--

_Deaths in Children under One Year per Thousand Births in Three Classes of Artisan Towns in Staffordshire._

CLASS I. CLASS II. CLASS III. Many Women Fewer Women Practically no Women engaged in work. engaged in work. engaged in work. 10 Years (1881–90) 195 166 152 10 Years (1891–1900) 211 177 167

The figures speak for themselves, and it will be noticed that while there has been a general increase in the infant death-rate, practically the same relative proportion has been maintained between the three groups of towns.

As the outcome of a paper I read before the Public Health Section of the British Medical Association, at the Annual Meeting held at Nottingham in 1892, the question was taken up by the Parliamentary Bills Committee, with a view to securing some legislative remedy, and an inquiry was instituted throughout England on similar lines to the Staffordshire inquiry. Returns were thus obtained from a large number of artisan towns, and these returns bore out in a remarkable way the conclusions drawn from the Staffordshire figures.

It appears, then, to be a fact that the State is permitting a practice to be followed which is directly responsible for the deaths of thousands of infants annually. Deliberate cruelty on the part of parents is a punishable offence, and in a strict sense starvation comes within this category; it does not seem to matter, however, what sort of food is provided, so long as, theoretically, some provision is made for the care of the infant during the absence of the mother. Possibly, in many cases, owing to ignorance and other causes, the infant might not receive any better care at home, but there, at least, the natural food would be available, and in the majority of instances it would be given. It is true we cannot legislate as to how mothers shall feed their infants, but surely it is not too much to ask that the legislature shall not allow any deliberate disregard of parental responsibilities.

The law at present does provide some amount of protection, by making it illegal for a mother to return to work under one month after the birth of her child; but although this restriction is valuable from the point of view of the mother’s health, it can hardly benefit the child, for, if factory work is to be engaged in after a month’s interval only, it is not likely that the mother will commence suckling her child. The period of restriction should undoubtedly be extended, and the shortest serviceable time is probably three months. The probability is that if such an extension of time limit were enforced the mother would suckle her child until she returned to work, and thus the most precarious period in the life of the child would be tided over, and its chances of survival would be considerably increased.

In many cases the wife--it may be from choice, or because of improvident habits on the part of the husband--goes to work, while at the same time the husband is earning ample wages. In Lancashire it is common for a man to receive 25s. a week while his wife earns from 15s. to 20s., and in Staffordshire, when the potting trade is ordinarily prosperous, the weekly wages of a man and his wife amount to 30s. and 12s. respectively. These figures represent a fair average, but many of the men workers receive much higher wages.

In seeking for a solution of the question, we may learn something from other countries. In Switzerland, for example, a period of absence from work of eight weeks is enforced on mothers, the time to be counted from two weeks before confinement; and in Germany, by a process of compulsory assurance, the working woman, while prevented from working owing to childbirth, receives a sum equal to half her ordinary daily wages. In the former case the period, for reasons already given, is not long enough, and the latter expedient could hardly be made applicable to economic conditions in this country. However, a way out of the difficulty ought to be found, and it would seem that it should be sought for in the direction of State control.

GEORGE REID.

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VI. CHILD LABOUR

The half-time system is dying. The age of the full-timer in the mill or factory is being steadily raised. But as long as poverty exists children must feel the pinch of it. They must help also to bear the burdens of their parents, and share their anxieties and cares. One would be very wrong, however, in supposing that the most anxious and harassed parents and children are to be found at the bottom of the social ladder. At the bottom of the social ladder will be found little care and much movement--a tourbillon of change--marriages, accidents, tragedies, crimes, all succeeding each other pell-mell, and obliterating one another. The parents and the children of the slums are occupied, not with thoughts of to-morrow, but with thoughts of to-day. Here, for example, is a large Board School in a slum district of a big northern city. It is difficult for the head teacher to keep the register, for large numbers of children are always flowing through the school like a shoal of mackerel on a tide. Families arrive, and encamp in the fair ground close by, or find shelter in the poor lodging houses of the neighbourhood. The children attend school for a short time, pick up a smattering of the three R’s., and then disappear. There are of course regular residents, and the children of such people are much better attenders. But they have this in common with their migratory neighbours, that their lives are varied by exciting and gruesome events, which they do not take to heart too seriously. A certain unfortunate mother of ten loses several of her children in succession. Then suddenly her husband, who is a drunkard, falls down some steps and is killed. There is a tragic gathering of friends at the house on the eve of the funeral. A few months later the widow marries again. But the second husband turns out to be a scamp. She leaves him and takes refuge with a married daughter. The children change homes, take the ups and downs of their rocky life, and attend school pretty regularly. Some children are deserted, and go into neighbours’ homes. The strong ties of kinship are dispensed with; and other ties, equally strong, for the hour at least, take their place.

Apart from the family drama, the children have their own struggles and adventures. They have to help to earn the living. In some families a child is the breadwinner. In many, children are important co-helpers with the parents. How does a child earn money? In provincial towns, also in London, the newspaper offices are responsible for a great deal of out-of-door child labour. A crowd of boys rush every afternoon to the “offices.” Some of these children are already employers of labour. They engage a smaller or less lucky comrade to deliver some of the papers, and pay him twopence or threepence, according to his success. They--the small employers--may earn 6s. per week and even more at times. Besides the newsboys there are the errand boys, and those who help shopkeepers. These form a large contingent of the children’s army of labour. And so, alas! do the vagrant sellers of chips, flowers, etc., who have to cultivate the beggar’s as well as the vendor’s art. At a Conference in April 1900 between the School Board and Board of Guardians of Bradford, a return was presented showing that 91 children--84 of whom were of school age--were found begging and hawking in the streets in the course of three evenings of December 1899.

The domestic toilers in such a district as that which we are now considering would be mainly nurses. Little cooking and less washing is done in some of the homes. There are no regular meals, no regular duties, and the elder children are useful therefore mainly in taking charge of the younger ones, or earning pence in the street. Taking their roving habits into account, it is strange to learn that such children suffer from lack of proper exercise. Yet such is the case. About a year ago Dr Kerr, the medical adviser of the Bradford School Board, made an examination of the children attending a school situated in an “insanitary area.” He found that nearly all the children were ill-nourished. And this ill-nutrition was not simply the result of insufficient food. “Lack of exercise,” he writes, “has a very large share in it. And the exercise required is not careful gymnastics, but coarse work, such as running round the playground.”

There are many kinds of physical exercise, just as there are many kinds of food, and one order of exercise does not take the place of another. Moreover, the same kinds of movements, executed under different conditions, have quite different effects. This is the important fact which is lost sight of by those who declare that the child can rest from the labours of the school by engaging in the labours of the mill. It is ignored also, or forgotten, by those rural educationists who believe that six hours of weeding or potato-picking mean the same thing for a child as six hours of free play. But the fact remains that work does not take the place of play, not even when that work is very easy, and involves walking or running. Here in this school of the slum, “careful gymnastics” are not required. And we may safely add that running about the streets, and the carrying of milk-cans and babies, are not required. For the children have had a good deal of this kind of physical exercise, and are suffering, nevertheless, from defective circulation and want of muscular tone. Only movements that imply the removal of tension from the nervous system are required. There is no real substitute for such free, natural movements in any factory, schoolroom, nor even we may add in any gymnasium in the world.

Let us turn from those whom we may call the “casuals” of the child-labour world, to the State-recognised little toilers who work in factories or mills. These form still a large contingent of the child-labour world, numbering as they do over a hundred thousand children, one-third of whom work in Lancashire cotton-mills. A goodly proportion, too, work in Yorkshire, the seat of the woollen and worsted trades. The rate of decline of the half-time system among factory and non-factory child-workers may be seen from the following figures, compiled in Bradford.

Number of half-time cases in Bradford in each year for the past twelve years:--

+-------+----------+-----------------+------------------+--------------+ | | | Non-Factory. | | | | Year. | Factory. | Domestic Errand | Total granted in | Number on | | | | Boys, etc. | each year. | School Roll. | +-------+----------+-----------------+------------------+--------------+ | 1889 | 3.194 | 679 | 3.873 | 7.046 | | 1890 | 2.567 | 575 | 3.142 | 6.490 | | 1891 | 2.129 | 708 | 2.837 | 6.151 | | 1892 | 1.838 | 728 | 2.566 | 5.624 | | 1893 | 1.653 | 540 | 2.193 | 5.097 | | 1894 | 1.434 | 655 | 2.089 | 4.178 | | 1895 | 1.887 | 580 | 2.467 | 4.309 | | 1896 | 1.509 | 306 | 1.815 | 3.276 | | 1897 | 1.451 | 250 | 1.701 | 2.564 | | 1898 | 1.329 | 314 | 1.643 | 2.211 | | 1899 | 1.187 | 193 | 1.380 | 1.869 | | 1900 | 1.444 | 129 | 1.573 | 2.198 | +-------+----------+-----------------+------------------+--------------+

The half-time system is dying fast in some towns, more slowly in others--but it is passing away even in Lancashire. No one appears to be more indifferent than the masters. It is not even fair to say that the masters are indifferent, for many of them have tried to hasten the end. And yet forty or fifty years ago the masters, as a class (there were, of course, honourable exceptions) opposed the raising of the age. Even ten years ago some masters showed concern when it was proposed to raise the age of half-timers to eleven. “Younger children,” they said, “have special aptitudes which the elder ones have lost.” The wails of regret came usually from masters who could remember long bye-gone days. “Ah!” they cried, letting their thoughts drift back into the dim past, “when the children came to us very young, say at five or six years old, a great deal was possible that has since become quite impossible! It is of no use to speak of that now.” No, it is of no use to speak of it, since the age had been raised, and raised again. And with every rise the commercial value of the child in the labour world has diminished. And now you may hear a manager say, “The child who comes at twelve years old is more dexterous than the one who comes at thirteen,” but the masters are evidently of opinion that so far as they are concerned the matter is no longer worthy of discussion. That the children come a year earlier or later makes little difference when the minimum age is raised to twelve.

The masters’ claim that the younger children had special aptitude, undoubtedly rests not upon fiction but upon fact. Every physiologist knows that the various sensory centres of the brain are plastic in early childhood, and that this period of plasticity is very short. It begins to wane already in the seventh year. Previous to this age, however, every human being is in a peculiarly receptive and responsive state. So that, during the first six or seven years “a great many things,” as the silk manufacturers said, “are possible.” For example, the sense of touch may be developed within very narrow limits, and complex and specialised movements may be learned so well that they become automatic. This can be done. It can be done only at great cost. (Probably the employers did not know the actual cost.) It implies the atrophy of many cells, the impoverishment of the whole life. It is a kind of psychic mutilation. But it can be done, and it has to be done quickly, since the spring tide of opportunity soon wanes. Alas! for the old adage, “It is never too late to mend.” The mending, and making, and altering time is over for a great many people at the age of eight, and of this employers were well aware, thanks to their opportunities for observation and experiment. So as the age of the half-timer was raised the masters’ interest in him declined, and the latter-day champion of the half-time system stepped forward in the person of the half-timer’s own father,--his father, not his widowed mother. For the “poor widow,” who looms so large in the consciousness of controversialists on the half-time question, is seen and known wonderfully little in the school attendance rooms, where applications for half-time are considered. The applicants belong very largely to the better class of working people. Mechanics, engineers, railwaymen, overlookers, and, now and again, a mill operative. Of course these various trades represent a great variety of wages. Some applicants earn but £1 per week, or even less, and out of this support a large family. But many earn from 30s. to £2 or £3 per week. Indeed, men with £4 and upwards per week coming in have been known to apply, though these are exceptional cases. It is certain that the average working-man champion of child-labour to-day is not a thriftless, irresponsible person. He is, very often, a man with money in the bank, with ambitions and views of his own, also with a will of his own, and a strong Trades organisation behind him, through which he can express that will. Neither is he a person lacking in parental susceptibility and ambition. It is almost impossible to overrate the influence which custom has on sentient beings. The caterpillars of the Bombyx Hesperus feed in a state of nature on the leaves of the café diable. Yet Darwin found that certain caterpillars of the Bombyx family, having been reared on another variety, refused to touch the leaves of café diable. They preferred to die of hunger. Thus caterpillars can become, in a sense, unnatural. Kindhearted people, too, may follow a course of conduct with their own offspring which appears monstrous to the stranger. In certain districts where child-labour is a tradition and custom, the very idea of associating it with inhumanity does not occur to the people. “Why, they mun be all clean off their heads,” cried a Yorkshireman, who had been hearing of poor parents who sent their sons to school till they were fifteen or sixteen years old. He had gone to “t’ miln” at seven, and it seemed to him that all “workin’ foaks” children should do the same.

It is not then to the parent you must go in order to learn what the effect of half-time is on the young. Nor need you turn with very confident hopes to the statistician. It is, indeed, a little discouraging to reflect how little the statistician can help us in establishing the most obvious ill effects of child-labour. The effect of half-time exemption a little while ago was to filter off a number of mentally sharp children who passed their standards rapidly and were ready to go to work at eleven. These bright children were a continual stumbling-block to the statistician. For example, it was proposed to test the vision of the half-timers and other children with a view to finding out the effect of the mill life on this important sense. Now the stupidest boys and girls are those who have most defective visual acuity. They are also the deafest.[40] And the bright children who went to the mill at eleven, are, of course, the children gifted with the keenest senses. By the time these bright young half-timers had got to full time, the duller ones came on as half-timers, and by their transference appeared to increase the percentage of defective vision with age in half-timers and diminish it among the non-half-timers. Thus defective vision apparently increased with the age of half-timers, only because those kept back by defective brain or eyes alone were half-timers at the age of twelve. This is but one example of the great difficulty of collecting reliable evidence to establish even the most reasonable assumption.

But it is hardly an “assumption” that children suffer in England through half-time labour, and unregulated toil out of school hours. You cannot put tired eyes, pallid cheeks, and languid little limbs into statistics, and yet when you see them they are more convincing than figures. And in many schools you can receive this kind of evidence. The younger children who work out of school hours have undoubtedly the worst time of it. They come to school looking dull and heavy-eyed. Some are irritable and restless, others so languid that they appear almost oblivious of everything around them. “It seems as if they haven’t the force to work through the school day,” said a young master in a school of very poor children. “They may be bright enough children, but they haven’t the strength to show it.”

The factory half-timers are doubtless more fortunate than the younger casuals; for the former have arrived at an age when many of the critical turnings of child life have been passed. And yet the child of twelve no sooner enters a mill than the teacher begins to see a deplorable change in him. He loses interest in his school work, his manners become rougher. Manners are forms of mental expression, so the teacher may presage from this fact alone a certain decline of brain power. But there are many other indications of decline. The other day a teacher showed me the copy-books of children who had been at the mill for one week, and allowed me to compare these with the work done by the same children while they were whole-day scholars. As full-day scholars they all did creditable work. Their sums were correct, their writing good, and books were kept perfectly clean. Yet in the course of one week the progress of months seemed to be cancelled: for the half-timers’ sums were all marked with a “W.” The writing was careless, the pages soiled and blotted. The children had changed and their work had changed. Their achievements had slipped from their grasp as a waggon slips back when driver and horse are arrested suddenly on a steep hill.

Indeed, though the factory child suffers less in some ways than the “casual,” he appears to be under certain great disadvantages from which the latter is exempt. Ask any master of an elementary school and he will tell you that the characteristic of the factory child is dulness. The casual is not dull. Not at all, he is glad to talk to-you about his “business,” and the chances of his work-a-day life in the street. Not so the young factory hand. After the first fortnight in the mill he is a disillusioned person. He does not want to talk about his work or his prospects. He loses interest not only in others but in himself.

What is the secret of this subtle change? Why does the factory boy of twelve become so torpid? It is because in the mill growth and development are arrested. At the age of twelve a boy or girl is still a child, not an adult. It is true he has passed already through certain stages of growth, but the whole period of growth and development has not come to an end. His sensory organs are as acute, rather more acute, indeed, than a full-grown man’s, and yet in the matter of sight and hearing he is inferior. It is through psychic development that the full harvest of the sensory and motor powers is reaped. This is why, at the age of twelve, if growth is to continue, the boy or girl should enter an atmosphere of varied mental interests and activities. The richer the forces of human life the more intricate will be the means by which they can be put into operation. The mill does not provide an atmosphere in which the new order of human development due at this hour can take place. “Still the mill-child is not always dull,” you will say, “sometimes he is very noisy.” Yes, at “loosing time” the mill-yard and streets ring with loud talk and laughter. But the noise itself proves the same thing as the torpor of the mill child. In the jostling and shouting of the youth or mill girl the scientist sees not a vice but a reaction. In the desire for alcohol, the feverish love of betting and gambling, we behold the revolt of nascent human powers. These human powers, so varied and so subtle, are dammed up all day long, without possibility of exercise or escape. So the wild torrent of life surges free at last round the mill-gates, and escapes in the voice and glance of the excited lads who learn to love gambling and betting to the despair of good people. “A weak or insensible limb is certain of rough usage,” said Donaldson, for, obeying a natural instinct, its owner will insist on having a sensation through it. If the whole nature is dwarfed or blunted, only violent pleasures can be appreciated.

It is said that the poor “have no room to live”; what is even as serious--they have no time to grow. As long as such is the case we may be sure that, despite all the efforts of educationists and philanthropists, there will be a great many undeveloped persons. Meantime the scientist advances, taking account of all, and stating all fearlessly. Year by year the processes of growth and development become clearer, and the conditions of human progress more defined. And although we cannot at once remove even the more obvious causes of arrested development and weakness, yet it must be evident to all that the future belongs to the nations who permit and enable their children to come to full human stature.

MARGARET M’MILLAN.

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VII. HOME-WORK

There is perhaps no section of industrial life regarding which so much misconception prevails as out-work, or, as it is popularly called, home-work.

To many persons the name home-work is synonymous with the idyllic term cottage industries, and this again calls up the picture of the model villager in the model village. The clean and tidy widow, so dear to the heart of the philanthropist and of the district visitor, is the favourite type. She dwells in an ivy-clad cottage surrounded by all the accessories of highly picturesque poverty, the kettle sings on her well-burnished hob, and geraniums bloom perennially on her window sill.

How does this picture compare with the grim realities of home-work in our city slums? We shall see from the cases which I quote further on, and which have been revealed by the investigations of the Scottish Council for Women’s Trades, and the Women’s Industrial Council of London.

The reason why the popular conception of home-work has lagged so far behind actual fact is, that this is practically the No Man’s Land of the industrial world. Here treads not the foot of the labour agitator, for the home-workers are composed largely of “casuals”--dreary phantoms, who come and go, whence and whither no man can tell, and no organising secretary of any trade union, however enterprising, would waste time or effort in inducing them to join its ranks. Each worker is a sort of industrial Ishmael, working only for his or her own hand.

Nor has the home-worker been much better off in respect of Government protection. For while the factory and workshop hand has had the conditions of her work regulated by law, the home-worker has been treated as a step-child by the State, and has been left outside the protecting pale of the Factory Acts.

Apart from the points of starvation wages and excessive hours, one of the main facts brought out by recent investigations into home-work is the grave danger to the health of both the worker and the community at large arising from the making of garments, etc., in disease-infected and otherwise insanitary houses, and public opinion has been gradually ripening to the conclusion that legal regulation of some kind is necessary as a protection to public health. Further, it is beginning to be recognised that the application to out-work of the laws that regulate labour in the factory is a perfectly reasonable and logical extension, as out-work, in the modern expression of it, is practically an extension of factory work, or it may be more properly described as its back-wash. Out-workers are employed mainly on the surplusage of the factory orders--the unskilled, poorly paid work that the workshop hand rejects, or that the pressure of a big order prevents her wholly overtaking. The low degree of skill required for the most part, and the consequent low earnings, have their inevitable result in placing this section of the industry in the hands of the very class of workers whose conditions most need supervision and control.

Previous to the passing of the Factory and Workshop Act of 1891, some agitation with respect to the conditions of home-work had begun to make itself felt, and in recognition of this a provision was made in that Act giving the Secretary of State power to require employers to keep lists of all the out-workers they employed. These lists were to be open to the inspection of the Factory Inspector and the Sanitary Inspector. This was carried a step further by the Act of 1895, in which it was decreed that copies of these lists should be sent twice a year to the Factory Inspector. But while the latter may visit the homes of the out-workers, he has no power to remedy any defects he may find there; all he can do is to report insanitary conditions to the Local Sanitary Authority; except, of course, in the case of out-workers who employ others to help them, and whose premises thus become a workshop within the meaning of the Factory and Workshop Acts, and are accordingly subject to their provisions. But these after all form a comparatively limited class; consequently the great majority of out-workers are left entirely outside the scope of these Acts.

The following cases will convey some idea of the actual conditions under which out-work is carried on:--

1. Is the wife of a labourer, who is sick and in the infirmary; works from twelve to sixteen hours per day finishing trousers; is paid 4½d. and 5d. per pair; earns 2s. per day; supplies thread and twist, which cost about 8d. per week; works in a very untidy, dirty kitchen. Has no time to clean up except once a week. Children carry the work to the workshop.

2. Is a widow living alone; finishes trousers; is paid 2¼d. and 2½d. per pair; earns 9½d. per day of nine and ten hours, and provides thread, which costs about 9½d. a week. Her earnings are supplemented by 2s. 6d. a week from the parish.

3. Married woman, husband out of work; finishes shirts; is paid 2½d. per dozen, and earns about 7½d. per day of eighteen hours; supplies thread, which costs about 8d. per week. When work is brisk she can earn 4s. 8d. a week by getting up at three and four in the morning.

4. Is the wife of a bricklayer; she works eight to nine hours a day making matchboxes; is paid 2¼d. per gross, and earns about 1s. 4d. a day. A girl of eight out of school hours helps the mother, who has to supply paste and hemp, which costs about 6d. a week.

5. Is the wife of a porter; works ten to twelve hours a day making matchboxes; earns 1s. 3¾d. per day, and her little boy, who is four years old, helps her by folding the paper after it is pasted over the cardboard.

6. Is a married woman; makes bead trimming; is paid ¾d. to 1¼d. per yard, and earns from 1s. to 1s. 6d. per day, working twelve to fifteen hours. Little boy of eight helps out of school hours.

7. Two girls work at fur-pulling eleven hours a day, and earn about 8s. 6d. per week each. Three girls sleep in workroom in one filthy bed. Elder girl said her chest was bad, but she was accustomed to this.

8. Is the wife of a labourer in irregular employment; finishes shirts, and works from 5 A.M. to 11 P.M.; is paid 2½d. to 5d. per dozen; pays about 1d. out of every 1s. earned for thread. The highest wage she ever earned was 4s. 10d. a week, “working late and early.” The eldest girl does the housework. House in filthy condition; work piled upon the floor.

9. Two single women living together, the daughters of a city missionary deceased; work about ten hours a day finishing children’s shirts and making pinafores, and earn from 4s. to 6s. per week each. On the day visited, one had worked seven hours and had made 7d. Her wages-book for ten consecutive weeks showed 2s. 4d., 4s. 4d., 5s. 8d. (week and half), 7s. ½d., 3s. 1½d., 3s., 2s. 3d., 3s. 9d., 3s. 1d., and 5s. House, attic room, beautifully clean, rent 8s. per month.

10. Is the wife of a labourer irregularly employed; has three young children; “makes shirts throughout and finishes them,” earns 5s. to 6s. per week, working twelve to fourteen hours per day. She pays 1s. 6d. per week for machine, and 4d. per six dozen for thread. Occupies house of two rooms, very dirty and almost destitute of furniture.

11. Is a widow; lives in one-roomed house, which is very dirty; “finishes” woollen shirts; is paid from 2½d. to 6d. per dozen, according to the amount of work put upon the garments. Her average earnings are from 5s. to 6s. per week. Two children were lying ill in the room, and were covered up with the shirts on which the mother was employed; she could not tell what was the matter.

12. Is the wife of a surfaceman earning 16s. a week; makes aprons, pinafores, and chemises, and earns about 5s. per week. She is in delicate health; has had eight children, only one of whom now survives.

And so on, through this dreary tale “of poverty, hunger, and dirt.”

The evidence collected in respect to out-work by expert investigators in these and other cases seems to prove conclusively that it is usually accompanied by very low wages, inordinately long and irregular hours, and distressingly insanitary conditions. With the matter of wages British legislators have not yet seen fit to deal directly, and it is obvious that any regulation of hours for work carried on by workers in their own homes would be extremely difficult to enforce. What remains is the sanitary condition of the house and of the worker. And there is the double ground for interference here, in that the making of clothing and other articles for public use in insanitary dwellings is not only a danger to the workers themselves, but also to the public generally.

How does the law on this point at present stand? Perhaps the most important legislation we have had dealing with out-work is to be found in sections 5 and 6 of the Factory Act of 1895, which contain the following provisions:--

See. 5. (1) “If an inspector gives notice in writing to the occupier of a factory or workshop, or to any contractor employed by any such occupier, that any place in which work is carried on for the purpose of or in connection with the business of the factory or workshop is injurious or dangerous to the health of the persons employed therein, then, if the occupier or contractor after the expiration of one month from receipt of the notice gives out work to be done in that place, and the place is found by the court having cognizance of the case to be so injurious or dangerous, he shall be liable on summary conviction to a fine not exceeding ten pounds.

(2) “This section shall apply in the case of the occupier of any place from which any work is given out as if that place were a workshop.

(3) “Provided that this section shall not apply except in the case of persons employed in such classes of work, and in the case of persons giving out employment and employed within such areas, as may from time to time be specified by the Secretary of State by order made in accordance with section 65 of the principal Act, and no such order shall be made except with respect to an area where, by reason of the number and distribution of the population or the conditions under which work is carried on, there are special risks of injury or danger to the health of the persons employed and of the district.

Sec. 6. “If any occupier of a factory or workshop or laundry or of any place from which any work is given out, or any contractor employed by any such occupier causes or allows wearing apparel to be made, cleaned, or repaired in any dwelling-house or building occupied therewith, whilst any inmate of the dwelling-house is suffering from scarlet fever or smallpox, then, unless he proves that he was not aware of the existence of the illness in the dwelling-house, and could not reasonably have been expected to become aware of it, he shall be liable to a fine not exceeding ten pounds.”

I have no doubt sub-section 1 of section 5 might have gone a long way to improve the sanitary conditions under which out-workers are employed, and reduce the danger to the public, had it not been for the restriction imposed by sub-section 3, which makes it practically inoperative.

Notwithstanding the many overcrowded and insanitary districts in our large cities, I am not aware that a single area has been specified to which the section should apply. The reason for this will probably be found in the difficulty to prove the existence of “special risks of injury or danger to the health of the persons employed and of the district.” And in any case the month’s notice to be given would simply mean that by a system of removing--which would be nothing unusual with the class of workers concerned--the purpose of the Act could be successfully evaded.

It would seem to be the desire of the legislature to place all responsibility for compliance with the law upon the employer, or the person giving out the work, but it stops short at providing him with the means of ascertaining whether the law is being complied with.

The limited space at my disposal will not allow me to deal with the many economic issues involved in the question of out-work. I can only make a brief reference to its possible effect on wages.

Many of the more intelligent workers in the factories and workshops speak very strongly against it on the ground that the long and irregular hours tend surely, if indirectly, to lower wages, and workshop hands in some cases, even where the total earnings were very low, have on principle refrained from taking work home to finish after the workshop hours, through fear of thus producing an artificial standard of wages. Out-workers are often used as a lever for reducing rates of wages. They are not restricted by any law to a specified number of hours per day as in factories, and they are often found working from early morning till late at night. With the help of some other members of the family, a fair wage may be earned, in consequence of which the employer is inclined to make comparisons which show the factory hands at a disadvantage. Subsequently rates are reduced for everybody.

It may be interesting to note that a large number of out-workers met with during these inquiries were in receipt of parochial relief, although they were working full time for their employers. Attention has been directed to this subject from time to time in the official reports of the Factory Department, and various suggestions have been put forward as to the best methods for the efficient regulation of home-work; but sooner or later the Government will be obliged to deal with this question, and as the matter will therefore be in the hands of the Home Office it would be unwise of me to anticipate the manner in which they might treat the subject.

A. BALLANTYNE.

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VIII. THE PHYSIOLOGY AND PATHOLOGY OF WORK AND FATIGUE

There is a limit to man’s power of doing work. This varies in different individuals. In an ordinary way work is conducive to health, and even under abnormal circumstances work is often the main factor that tends to prolong life. Mental not less than physical occupation has been known to raise men and women above worries that otherwise would have crushed them and lifted them above the depressing influences of an incurable malady. In itself work is a good thing. It is when we come to consider the effects of overwork and fatigue in an age when all is hurry and excitement, when every one is pressed, and work is undertaken under such unhealthy conditions as exist in some overheated, overcrowded, and ill-ventilated factories, that one of the worst sides of excessive toil is seen. In order to understand more fully the evils of overwork and fatigue, physical and mental, let us learn something of the physiological conditions under which muscular work is performed.

We are frequently reminded that the human body resembles a steam-engine. From the circulation within the body of the absorbed products obtained from digested food are evolved those chemical and mechanical forces which direct all work, physical and mental. The human body differs from the steam-engine in being able to transform some of the food products into living tissue, whereby during work it calls upon its stored-up energy and loses weight. Human life can only be supported by oxygen and the ingestion of foods of vegetable or animal origin. In the internal laboratory of the human body chemical changes are continually taking place, resulting in the formation of such waste products as carbonic acid, water, and urea. These have to be removed by the lungs, the kidneys, and skin. A pure atmosphere, healthy surroundings, and an adequate supply of water and proper food, are therefore required in order to introduce into the system the ordinary necessaries of life. Health can only be maintained by a normal functional activity of the emunctories, whereby waste products are eliminated.

All organs when in a state of greater functional activity than usual draw to them, by a kind of automatic arrangement of the nervous system, a larger supply of blood. The demand upon the muscles of the labourer is met by an increased flow of blood at the time, therefore, when most required, and when changes within his muscular system are most active. In a similar fashion, a quickening of the cerebral circulation occurs during the processes of thinking and mental attention. We are, however, at this particular part of our inquiry concerned rather with that large army of workers, men, women, and young persons, who are either day or weekly wage earners, whose life is one of hard toil, and who in reaching home of an evening are frequently tired out with the day’s labour. Work while physiologically making for health may, if pushed too far so as to induce fatigue, ultimately unfit the individual for his allotted task.

By means of an instrument known as the ergograph, physiologists can estimate the amount of muscular work done. We can thus learn something of the laws of muscular activity and of fatigue in man. Work is only done by muscle when it is contracting. By means of the ergograph we can register the character, the frequency, and rhythm of these contractions, and estimate the weight of a load lifted, or the amount of work accomplished, in a given time. In addition to the physical work accomplished, heat is also generated within the muscle, and certain waste products are formed which escape by the veins and lymphatics. A healthy fresh muscle responds practically at once to an electrical stimulus, but when it has been over stimulated so that the individual muscular contractions follow each other too rapidly, the tissue becomes fatigued and no longer responds to the induction shocks. The ergograph shows us the manner in which we become fatigued. Professor Mosso, of Turin University, found that the instrument registers very much the same results in the same people over a period of years, allowing for certain minor modifications depending upon the conditions of the organism, the state of health at the time, diet, sleep, and the amount of intellectual fatigue present at the moment. We are all familiar with the influence of volition upon muscular contraction. By a strong effort of will we can force our jaded muscles still to accomplish work, but in doing so we often add to the muscular tiredness a sense of brain fatigue as well. There is a marked difference in the character and amount of work done by muscles that have been gradually trained compared with that done by those not so prepared. Professor Aducco found that at the end of a month, after having practised a few hours daily with the ergograph, he could perform twice the amount of muscular work than he could at the commencement. A moderate amount of work, physical and mental, is attended by a feeling of pleasurable satisfaction. It is when work is carried too far, and when a man’s daily labour becomes too hard, or makes lengthened and unusual demands upon his strength, that there is experienced a sense of extreme weariness and fatigue. When a muscle has become fatigued its irritability is lessened. It no longer contracts with the same vigour, less energy is set free, and the muscle relaxes and regains its original form less quickly. Under any circumstances energy is only liberated at the expense of the nutriment stored up within the muscle and the oxygen absorbed from the blood. A process akin to oxidation takes place within the muscle during its contraction whereby waste products are formed that act as poisons to the muscle protoplasm. Muscle is only capable of doing work so long as energy holding explosive compounds are formed within it and the waste products are excreted.

What, then, causes fatigue? Since during muscular contraction oxygen is absorbed, and carbonic acid and other waste materials are formed, fatigue might in the first instance be considered as dependent upon processes of a chemical nature, and be due to the non-removal of the harmful substances formed by muscle when doing work. That fatigue is largely the result of this is shown by passing some simple saline solution through the blood-vessels of a limb removed from a recently killed animal, and where the muscles of the limb have been thrown into a state of fatigue by excessive stimulation. As the liquid percolates through the muscles and washes out the waste products, fatigue disappears, and the muscular contractions on stimulation become again as vigorous as they were before. Over-use of muscles obliges us to breathe more frequently. By increased frequency of respiration the temperature of the body is lowered owing to evaporation of water from the interior of the lungs. Add to this the cooling influence of the air inspired, for it is of lower temperature than that within the lung. Respiration too is the medium through which we throw off the excess of carbonic acid from the blood. As long ago as 1845, Helmholtz, a German physiologist, demonstrated that when a muscle is in a state of repose it contains very few substances that are soluble in alcohol. For the sake of comparison we shall name this amount 1. In fatigued muscle the quantity of these soluble substances rises to 1.3. Healthy muscle in repose has an alkaline chemical reaction, fatigued muscle is acid. Some of the substances formed during muscular contraction possess distinctly poisonous properties and are toxic to the individual himself. While fatigue is induced by local conditions in the muscles, the sense of tiredness which we experience is the result of general rather than local causes. During the course of a long walk, or a day’s hard toil, the muscles are constantly forming waste products which it is the function of the internal organs to throw out of the system. It is not deprivation of food, for example, that is the cause of fatigue, although it may be contributory. The real cause is the circulation in the blood of fatigue products. These act upon the nerve-endings in muscle and paralyse them, and they also act upon certain portions of our brain, and create the sense of fatigue. Ranke made an aqueous extract of fatigued but otherwise healthy muscle, and taking the poisonous substances he injected them into a living muscle that had been removed from a recently killed animal, with the result that its power of doing work at once diminished. Were it not for the watchful activity of our emunctory organs, e.g., the liver, kidneys, skin, and bowels, the human body would soon be poisoned by the toxic substances formed within the system. The sensation of fatigue is due to the temporary retention of these harmful substances. The blood of a fatigued animal is more poisonous than that of a healthy one which has been in a state of quietude for some time previously. When some of this blood is injected into a healthy animal, it induces the phenomena of fatigue. If, for example, the blood of a fatigued dog is injected into a healthy one, the receiving dog will shortly afterwards show signs of fatigue, creep into a corner and go to sleep. The effect of hard work upon the blood is also shown in a diminution of its hæmoglobin or colouring matter. When we are mentally tired, it would seem as if the sensation of fatigue was located in or depended upon certain conditions of particular portions of our brain, for if we change the subject of meditation or take up some game that requires even a great amount of thought, e.g., chess, the sensation of tiredness often disappears. It is difficult to prove whether brain or muscular work is the more fatiguing. It depends upon the training, the occupation, and constitution of the individual. The personal element is a factor in fatigue that cannot be ignored. Prima facie, owing to nerve tissue being the more highly organised, this circumstance suggests that the brain would be the more easily fatigued. Against that must be placed the fact that the muscles form a much larger portion of the body by weight than the nervous system, and consequently within them must be formed a much larger amount of poisonous waste material. Some people we know are more easily tired than others, both mentally and physically. There is for each person apparently a definite rate of muscular contraction essential to the amount of work accomplished in a given time. If this is true for the muscular, it is none the less so for the nervous system. People who have inherited a weak nervous system become readily exhausted, even with very little work, and they recuperate slowly. They are said to suffer from neurasthenia, or nerve weakness. In addition to muscular work being accompanied by the production of toxic substances, it should be remembered that the individual is perhaps standing all day at work in a heated factory, and as a consequence of the fatigue the circulation becomes languid, and his feet swell. Muscle can after all do only a limited amount of work, and in order to recover from fatigue there must be a period of repose or relaxation. This raises the question of the number of hours per day a man should work, also the length of the break for the mid-day meal. On the Continent the mid-day break is in some factories longer than it is in this country, but the work is carried on further into the evening. It is admitted that in iron works and factories, where the hours of labour have been unusually long, say ten and eleven hours, the work done in the latter part of the day is not so good as that done in the forenoon, and managers say that where the experiment has been tried, the men have turned out in eight hours an amount of work equal to what was previously done in nine. The problem can only be solved by experience. It is right to mention that fatigue does not always, or necessarily, depend upon the amount of work done. A good deal depends on the state of the body at the time. We know that good work can never be done by a tired brain or fatigued muscles, and that the amount of work accomplished is always greater where the limit of exhaustion has never been reached. If we are tired and feel that we have to make a fresh spurt to accomplish something, the end, it is true, may be gained, but it is by using up a certain amount of reserve force stored away in our muscles, and by making an additional demand upon our nervous system. The physical fact of muscular fatigue has its psychical counterpart in the sensation of tiredness. When muscular work is light and of short duration there may be only a sense of weight, but if the labour has been hard there may be a sensation of actual pain which continues for a time. Intellectual work when carried on too long and without sufficient recreation, interferes with the innervation of the heart and blood-vessels. In cerebral fatigue there are often languor, or its opposite restlessness; the pulse may be small and excitable; the head hot, the feet cold, and there may be noises complained of in the head. The nervous control of the blood-vessels is destroyed, so that while the extremities are cold and their blood-vessels small and contracted, those of the brain may be dilated and overfilled. Protracted brain work is followed by irritability of temper, by inability to concentrate the attention and to reason out problems. It becomes an effort to think. There is headache, for the brain is, in a similar manner to the muscles, affected by the circulation through it of waste products. These at first, like alcohol, may stimulate and excite the brain, but they end by paralysing it. It is an interesting fact that while the brain is particularly sensitive to the action upon it of poisonous substances and of an altered circulation, as seen, e.g., in bilious headache, the headache of kidney disease, plumbism, etc., the surface of the brain is insensitive to touch, as is demonstrated in cases of injury to the skull where the brain is protruding. The brain can be gently touched without any sensation being experienced; if there is any at all, it is certainly not one of pain; any effects that follow are the result of pressure. While insensitive to a great extent to touch, the surface of the brain will respond to an electrical stimulus. Levy (British Medical Journal, 13th September 1900), after stimulating the motor areas of an animal’s brain by electricity, found that fatigue was rapidly induced, and when this occurred, that the brain failed to respond to fresh stimulation until after a period of rest. When interruptedly stimulated, so that there are periods of rest, the brain does not become readily fatigued, but is rendered capable of expending a greater amount of energy.

Hodge (Journal of Morphology, 1892) has studied the effects of work upon nerve structures. He found after prolonged electrical stimulation of spinal nerves certain structural alterations in the cells of the ganglion on their posterior root. When the nerves were over-stimulated the cells became shrunken, their protoplasm crenated and vacuolated. The amount of shrinkage was proportional to the length of stimulation, e.g., if it was continued for--

1 hour there was 22 per cent. } 2.5 hours „ 21 „ } Shrinkage in volume 5 „ „ 24 „ } of the nuclei of the 10 „ „ 44 „ } stimulated cells.

Hodge’s experiments demonstrate that there is a relation between the amount of structural change in nerves and the length of time during which the stimulus has been applied. The influence of rest in restoring the cells to their normal size was equally apparent. In order to determine how far these changes were really dependent upon work, Hodge examined the nerve-cells of birds and bees after a day’s work and after a night’s rest. At the beginning of the day, when the animal had rested over night, the nerve-cells were found to be large and turgid, and with prominent nuclei, but after a day’s work, the contents of the cells were vacuolated and shrunken, and their nuclei altered in shape.

Dr Guido Guerrini (Lancet, 21st October 1899, and 10th November 1900) confirms the statement just made, that as a result of fatigue the nerve centres exhibit certain alterations of structure. Beyond being more vascular than usual, a fatigued brain does not exhibit anything special to the naked eye. Guerrini caused dogs to run a certain mileage every day, but it was not until they had covered a distance varying from 22 to 61 miles that they appeared fatigued. On examining their brain microscopically, he found the lymphatic spaces around the cells distended, the chromatin network of the brain-cells changed, and the pigment disintegrated, while the protoplasm exhibited numerous vacuoles, the outline of the nucleus was irregular, and its contents vacuolated. These changes were always proportional to the amount of fatigue undergone by the animal, and were most pronounced in those parts of the brain known as the motor areas, i.e., those which innervate the muscles. The cause of these alterations of structure in nerve-cells in fatigue is the circulation in the blood of waste products formed during work. The presence of this waste material in the blood not only creates a sense of fatigue, but so alters the structure of nerve-cells that they require a lengthened period of repose before they become quite recuperated. Additional changes were found by Guerrini in the liver and kidneys. On examining these organs in fatigued dogs, he found that there were changes in the cells of the convoluted tubules of the kidney, and in the loops of Henle. The cells were observed to be larger and more brittle than in health, so that they readily disintegrated and filled the tubules with débris, in the midst of which the liberated nuclei could be seen. The liver cells too were found to be enlarged, and the seat of cloudy swelling, which is always one of the earliest indications of pathological change occurring in cell protoplasm.

In considering the question of work and fatigue, there are in addition certain other factors that cannot be ignored, for example: (1) the social conditions in operation upon the individual at birth, and during his upbringing; (2) habits such as the use of alcohol; (3) the atmosphere in which his work is carried on; and (4) the nature of his employment, and the number of hours per day spent at it.

Roughly speaking, the working classes may be divided into artisans, the majority of whom make good wages, are well housed, well clad, and well fed; and into labourers, who do unskilled work, whose occupation is irregular, and who, when out of work, are not well fed.

To some even of the regularly employed labouring classes, when the family is large and the wages small, or where work is interrupted on account of recurrent ill-health, life is a hardship, and the children are occasionally more or less deprived of their proper food; while in the case of the textile industries where women are employed in the factories, the infants, bereft of maternal attention and proper nutriment, necessarily suffer. The children born in the alleys of our large towns cannot, as they grow to manhood, be possessed of that well-developed bodily frame required to fit them for undertaking hard muscular work. The offspring of parents, both of whom work in textile or jute factories, are inferior in size and general physique to children born under healthy surroundings and under more normal conditions. When these grow up and enter the factory as half-timers, their rate of growth lags far behind that of children of their own age who still remain at school. The trend of civilisation is for hard manual labour to be more and more replaced by machinery in all industries. By some social economists, however, as we shall see later on, this is not always regarded as an unmixed benefit. When a child commences work and earns a weekly wage he is to that extent more able to procure the additional food his growing frame requires. From this point of view the object is good; and if only the physical labour is gradually undertaken, is not too long, and is tempered to the strength of the juvenile worker, the training, like the muscular exercises alluded to in the earlier part of this paper, may be beneficial than otherwise. It is not always thus, however, with children who go into factories. Children brought from the country, and with good physique to start with, will be found after two years’ work in a mill in a large town to exhibit a smaller rate of growth than those who engage in outdoor work. The children of the poorer classes commence life at a great disadvantage compared with those of the well-to-do. There is more sickness, and the death-rate among them is higher, owing very largely to bad feeding, exposure, and neglect. Pagliani found as a consequence of women continuing to do hard muscular work when enceinte, and commencing their industrial duties again too soon after their confinement, even though giving their infants the breast, that the children were of shorter stature and of feebler force than those not similarly treated. A fairly reliable test of the effect of severe manual labour upon children in Continental countries is seen in the large number of conscripts rejected from military service on account of some physical disqualification. In no place perhaps more than in Sicily are the harmful effects of fatigue and exhaustion on young people so apparent. An excessive proportion of the conscripts who had been in their earlier years engaged in carrying heavy baskets of sulphur out of the mines near Catania are found to be physically feeble, ill-developed, and unfit for military service. Is a similar condition of things, although to a minor degree, not taking place in our own country? The standard of height and of chest measurement required of recruits is not rising but falling. The improper feeding, bad housing, imperfect clothing, and absence of pure air in the home, which are the lot of an increasing number of the poorer working classes, are not the conditions that favour the development of such healthy labouring people as are required to enable us as an industrial community to compete with other nations, perhaps more favourably circumstanced. The point is, whether in this respect other nations do not come under the same ban as ourselves.

After work there must be relaxation, in order that an opportunity may be given for the muscles to recuperate, and for waste products to be removed. For working men, physical rest and recreation, sleeping in good air amid healthy surroundings, are desiderata, and yet how few there be who find these. With the toil of the day over, home reached and supper finished, there is little in the immediate dingy surroundings that is attractive, and so the working men saunter out to the nearest street corner to converse with their comrades, or adjourn to a public-house, where in an overheated bar and ill-ventilated rooms the remaining hours of the evening are spent. Nor is the married working woman much better off, so far as rest is concerned, for after her day’s work in the factory she attempts to overtake, often unaided, her neglected maternal and domestic duties. It is desirable that healthy recreation for our working classes should be provided to a greater extent than it is. In this matter employers could do a great deal. The proper housing of the working classes is even a greater need. How can the poorer working men have good health, good morals, and be long lived, when they do not have in their homes and surroundings those conditions that enable them, during periods of relaxation, to sleep well, and to eliminate by their lungs and skin the waste materials formed during toil. After all, we are each of us, physically and mentally, very much what the circumstances of life make us. Personal, not less than national character, is partly moulded by external surroundings.

The habits of the poorer working classes, too, as regards alcohol are not without their bearing upon this important question. It is a subject, therefore, upon which there should be some definite expression of opinion, especially since both at home and abroad there is a belief that alcohol is a necessity for the working classes. This matter has been recently brought to the front in France by the socialist leader, M. Fournière, in an address delivered to working men, the gist of whose argument is, that alcohol is a hydrocarbon, capable of supplying during combustion within the body the necessary elements for muscular work, and that therefore it is a food. Among foods of the hydrocarbon type Fournière places alcohol in the first rank. He maintains that the insufficient food of the workman imposes upon him the necessity for alcohol; his hard work creates a desire for it. Alcoholism as a social infirmity is therefore regarded as a direct consequence of the excessive demands made upon the muscular system by present-day labour. This is dangerous teaching to working men, and cannot be allowed to pass unchallenged. The insufficient food of the working man is in many instances the result of his small wages and uncertainty of employment, but it is a monstrous evil for any political leader to recommend him to spend more of his wages upon drink. Money purchases less alcohol than food; besides, what is spent upon alcohol is consumed by the individual himself, leaving less of the wages, therefore, to be spent on food for his wife and family. It is pandering to selfishness, and the teaching tends to encourage the idea that what a man produces by his labour he has a sole right to spend upon himself, leaving to Society the care of those who are naturally his own. But quite apart from this side of the question, what is the teaching of physiology?[41] It can be shown that the administration of alcohol in more than moderate doses is followed by a diminution of muscular energy, which fresh doses of the stimulant do not readily compensate; that to the period of excitement there succeeds one of depression, so that in a given time the amount of work accomplished under alcohol is less than that done without it. I think I may safely say that no literary man ever did his best work under the influence of alcohol. In moderate quantities alcohol stimulates the brain for a brief period, and quickens the flow of ideas, but this is followed by a reaction of depression. In a paper read before the Académie des Sciences, January 1901, M. A. Chauveau detailed the results of his experiments upon alcohol and muscular work. He set himself this problem: how far a man who works and whose blood is saturated with alcohol obtains from the combustion of alcohol the energy necessary for the functional activity of his muscles? In order to estimate this he measured the “respiratory quotient,” that is to say, the relation existing between the volume of carbonic acid excreted and the amount of oxygen absorbed. His conclusions are drawn mostly from dogs. In an ordinary way meat and sugar were administered to these animals, and subsequently for 84 grammes of sugar 48 of alcohol were substituted. Under the normal feeding the mean respiratory quotient was 0.963, but during the period of the administration of alcohol it only reached 0.922. Chauveau proved by this and other means that alcohol is not utilised as potential energy either for the execution of physiological functions acting together in a state of repose or for muscular work during states of activity. In substituting alcohol for sugar he found in a given time--(1) a diminution of muscular work; (2) loss of body weight, and (3) increased expenditure of energy relative to the amount of work accomplished. We are familiar with the fact of the large quantities of stout consumed by the London dock labourers, who, either as the result of experience or imagination, have come to look upon malt liquor as a necessity and as a food. Without denying the fact of stout in small quantities when taken with food supplementing, through its hydrocarbons and the sugar it contains, muscular energy, it can only to a limited extent contribute to those combustion processes from which the muscular system derives the necessary energy for its functional activity. Reverting for the moment to Chauveau’s experiments, it was found that during the period of normal feeding a dog ran a distance of 23.924 kilometres every day in two hours, and that its weight increased 1.245 kilos.; but during an equal length of time when it was taking alcohol instead of sugar, the distance coursed in the two hours daily was only 18.666 kilometres, and its weight fell 115 grammes. It is true that we cannot apply in toto the results of this experiment to man, but they are not without their meaning. Sugar is a well recognised muscle food. The experiment shows us that in dogs, when alcohol is substituted for sugar, the result is not to the advantage of the individual. There is a diminution in the amount of work done. More than this, alcohol tends, and the more impure it is the greater the tendency, to load the blood with harmful substances, and to induce pathological changes in such of the eliminating organs of the body as the liver and kidneys. Even admitting that it may contribute to the production of muscular energy, it imposes upon these organs a greater burden than a proportional quantity of food, and thus it happens that as a consequence of the circulation within the body of the toxic substances formed in muscle during work and of those derived from alcohol, also the fact that alcohol checks the power of the liver and kidneys to throw off the toxic material circulating in the blood, there are induced at an early age in working men who are intemperate, pathological changes in the liver, kidneys, and nervous system, structural alterations which play a very large part in the causation of the high death-rate of the poorer working classes.

In considering the question of fatigue of working people we must not overlook the nature of their employment, the rooms in which the labour is carried on, and the number of hours daily spent in work. When the air in a factory is close, and is not renewed frequently enough, there is an impediment to the escape of carbonic acid from the lungs, and when the air is overheated and moist, the natural cooling of the body through respiration cannot occur. Labour carried on under these conditions entails an additional tax upon the strength of the workers and burdens their system with impurities. We live in an age that creates, because there is a demand for, labour-saving machinery. The introduction of steam has revolutionised industry. Manufacturers keep increasing their production and throwing goods in larger quantity and at lower price upon the market. Machinery acts with unerring uniformity. At times so simple is its mechanism that a child can almost guide it, yet how exacting are its demands. While machinery has in some senses lightened the burden of human toil, it has not diminished fatigue in man. All through the hours of work in a factory the hum of the wheels never ceases. Requiring constant attention, to stop the machinery running is to lose money, and so men and women are obliged to wrestle with the forces of steam and mechanical ingenuity. While the machinery pursues its relentless course and is insensitive to fatigue, human beings are conscious, especially towards the end of the day, that the competition is unequal, for their muscles are becoming tired and their brains jaded. In many factories the system of double shifts allows the work to be carried on by night as well as by day. It is not urged that where double shifts of men are employed and the work conducted in well-ventilated factories, the shifts alternating every fortnight (night being the ordained period for man’s rest) with no Sunday labour and Saturday afternoons off, that the double shift system is necessarily prejudicial to health. But what shall we say of double shifts that practically never know of any interruption? A short while ago I visited a large iron works on the Continent where steel rails were being made. By means of a day and night shift the work went on continuously. On the occasion of my second visit to the works at eleven o’clock at night I met with a strange sight. The men were working almost naked; they were only wearing loose, coarse cotton garments like shortened nightdresses, and even in these they were bathed in perspiration. As they flitted about in the darkness, lit up by the lurid glare of the furnaces, they looked more like demons than men. For nearly seven years had the furnaces been going almost without cessation. From the first day of one year to the commencement of that following, Sunday, Saturday, and Christmas Day, the men had worked their particular shift, never knowing what twenty-four hours’ respite from labour was unless when off ill. The company pensioned the men when they were too ill or too old to work, and gave them a house with a small garden and pasturage for a cow; but what availed these when the best years of the workmen’s lives had flown and the enfeebling influences of old age had fallen upon them? The men were old at the age of forty, and many of them were broken down in health. It is the continuous demands made by machinery that are so trying, there being no time left for relaxation. Presentday factory labour is too much a competition of sensitive human nerve and muscle against insensitive iron, and yet, apart from an appropriate shortening of the hours of labour, it is difficult to see how this can be remedied. The greater the number of hours machinery runs per day the larger is the output for the manufacturer, but the feebler are the human limbs that guide it. To the machine time is nothing; to the human being, each hour that passes beyond a well-defined limit means increasing fatigue and exhaustion. There are some social economists, Marx among others, who maintain that while machinery has diminished the price of products it has made the lot of the worker worse, since by disregarding human strength it has introduced into factories a larger number of women, thereby reducing wages and diminishing the number of men required; so that, while there has followed a diminution in the number of hours of employment, the tension when at work is greater, and the output larger, thus resulting in more work being done. Machinery, too, by obliging man to do and to keep at one particular detail of work, is reducing him to a mere unit, and causing him to be ignorant of the other processes of manufacture, and to be less and less the handy man of an age now all but past. It remains to be seen how far this enforced relegation of man’s labour to the production of one particular product is for his own ultimate good and that of Society.

There is, it seems to me, too great a tendency even on the part of working men themselves to insist upon uniformity in regard to the number of hours they shall be employed. This is seen in the attempt to nationalise an eight hours’ day for coal-miners, when it is known that in Northumberland and Durham they do not work eight hours from bank to bank. There are local and social conditions that cannot be ignored, and before which the leaders of working men must bow. As regards dangerous trades, it goes without saying that the number of hours spent daily in a factory should be fewer than in healthy trades or in outdoor occupations; and a similar remark applies to those industries in which the work is hard and makes severe demands upon the muscular system of the labourers. It was surely never meant that work should be other than invigorating to man, and educive of all that is best within him. Healthy persons, therefore, should work to keep healthy; those who do not work, miss one of the greatest charms of life and stimuli to health. Fatigue is not due to work but to overwork, and excess of every kind is injurious.

THOMAS OLIVER.

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IX. MORTALITY OF OCCUPATIONS

Having undertaken, at the invitation of the editor of the present work, to contribute a section on the mortality of occupations, I think it just to him and to my readers to premise that inasmuch as the results of the forthcoming census cannot possibly be available for a considerable time to come, the statistical data on which I shall have to base my present observations must inevitably be those which were collected some years ago for the purposes of the second volume of my previous work.[42] And, seeing that those data were to a large extent exhausted in the preparation of the work referred to, it follows that I can offer comparatively little that is actually new in the remarks which I am now about to submit. The best that I can hope to accomplish is to select from the mass of statistical matter that was compiled for my larger work such particulars as may seem appropriate for the present article, adding from time to time such explanatory comments as a careful review of my previous book may show to be desirable.

Before entering on a discussion of the special subject with which the present essay is concerned, it may be well to offer a few preliminary remarks on the variations of mortality in general, as affected by conditions other than those of occupation, and in different parts of the country.

In a paper read before the Royal Society in 1859, my distinguished predecessor, Dr Farr, produced evidence to show that in sixty-three of the registration areas of England and Wales, which he designated “Healthy Districts,” the death-rate in 1845–50 did not exceed 17 per 1000 persons living. Improvement in the health conditions of England and Wales has now made it practicable to establish a higher standard for healthy districts: for whereas in 1845–50 less than 6 per cent. of the total population lived in localities where the death-rate was 17 per 1000, we are now able to state that in the years 1881–90 not less than 25 per cent. of the people lived in districts where the death-rate ruled below 17 per 1000, including a proportion of 4.5 per cent. in districts where the death-rate did not reach 15 per 1000. At the same period the general death-rate of England and Wales was 19 per 1000 living: about one-fourth part of the English population experienced a death-rate of from 12 to 16 per 1000, one-half were subject to death-rates ranging from 16 to 22 per 1000, whilst one-fourth part of the population experienced death-rates varying from 22 to as many as 36 per 1000 living, or more than double the rate obtaining in the healthy districts. It is not of course suggested that these enormous differences of mortality are to be accounted for exclusively by circumstances of locality, or even by circumstances of occupation and locality combined. The true causes of excessive local mortality are for the most part well known to the sanitary authorities who are responsible for the health and well-being of the communities among whom such unfavourable conditions prevail; in any case, these causes cannot be specially discussed here.

The foregoing remarks, with respect to fluctuations in general mortality, may have little obvious bearing on the subject in hand, namely, the mortality of occupations. But I adduce them in order to assist in explaining what will be further emphasised later on, i.e., the fact that even in the same industry the workers in various places experience wide differences in their mortality--differences which can only be accounted for on the theory that conditions of environment determine, to a greater degree than is usually believed, whether the mortality of a given industry shall be favourable or the reverse.

In connection with each of the last four census enumerations, and with the aid of the death registers for the several intercensal periods, attempts have been made to ascertain the influence of occupation on the health and vitality of the people. The results have been published in successive “Decennial Supplements,” and to these works reference must be made on points of detail. The earlier investigations of Dr Farr, which were based on the census populations and the deaths in 1861 and 1871, were limited to the mortality from all causes incidental to men engaged in certain well-defined occupations--account being taken only incidentally of the diseases to which that mortality was due. This omission, however, was supplied by Dr Ogle in the third Decennial Supplement, which dealt with occupational mortality in 1880–2. On that occasion Dr Ogle undertook the laborious task of abstracting and analysing large numbers of deaths in combination with ages, causes, and occupations, and thus succeeded in preparing the valuable series of tables concerning “causes of death in different occupations” which illustrate his work.

For the last decennial supplement I am myself responsible. In Part II. of that work the calculations were based on the population, as enumerated at the census of 1891, and the deaths registered in the three years 1890–2. Details of age, occupation, and cause of death, with respect to every male over fifteen years of age who had died during these three years, were abstracted from the registers and entered on separate slips of paper: these slips, more than half a million in number, were then examined by specially selected clerks, who had been employed in classifying occupations for the census reports, and each slip was distinctively marked with the heading under which the occupation should fall.

In the course of the work it speedily became apparent that the mortality of men employed in the several occupations is seriously affected by the surroundings in which they work, and, as before mentioned, these surroundings vary considerably, even for the same occupation, in different parts of the country. In order to ascertain, if possible, the extent to which the mortality of certain occupations was modified by these conditions, the following plan was pursued: the slips belonging severally to London, and to certain groups of districts the populations of which are mainly engaged either in industrial, in agricultural, or in mining pursuits, were counted separately from those belonging to the remaining parts of England and Wales, and the mortality of the same occupations was ascertained in each of these areas.

The group of Industrial Districts was constituted as follows--The county of Lancaster was selected as the seat of the cotton industry; the towns of Huddersfield, Halifax, and Bradford, as that of the woollen industry; Wolverhampton, Birmingham, Leeds, and Sheffield, as that of the iron and steel industry; and Leicester as concerned in the manufacture of boots and hosiery.

The Agricultural Group contained all those counties of England and Wales in which at least one-third of the occupied males over ten years of age were returned at the census as farmers and farm labourers; to these were added parts of counties in which, after exclusion of some of their principal towns, a like proportion of the population was found to consist of farmers and their labourers. In order to avoid possible confusion, as between different grades of labourers, it may be mentioned that all those who were described simply as “labourers” in these agricultural districts have been reckoned here as “farm labourers.” For comparison of the mortality among coal miners in different parts of the country, separate statistics for this industry were compiled for the following six local areas: (1) Durham and Northumberland, (2) Lancashire, (3) The West Riding of Yorkshire, (4) Derbyshire and Northamptonshire, (5) Staffordshire, and (6) Monmouthshire with South Wales.

The extracts from the death-register were limited, for the purpose of my Decennial Supplement, to facts concerning males aged fifteen years and upwards. Hitherto no attempt has been made to deal with the occupational mortality of females. The uncertainty attaching to the statement of occupations in the case of females has been urged as a reason against such an attempt. Much importance has also been held to attach to the fact that only 38 per cent. of the women aged between fifteen and sixty-five years were returned at the census as following any definite occupation, whereas 94 per cent. of the men at the same ages were so returned. Having regard, however, to the vastly increased attention which is now devoted to female industries, especially those which are carried on under the control of the Factory Acts, it is much to be desired that the mortality of the more important of these industries, at any rate, should be subjected to careful statistical investigation at the earliest possible opportunity.

The choice of an occupation by a labouring man is not always, nor is it mainly, determined by personal caprice. It is matter of common observation, that in industries of the more laborious type, such as those of railway navvy, engine fitter, boiler maker, blacksmith, etc., only men in the prime of life, or of more than average physique, are to be found. The operatives in these industries are selected men, quite as much so as are soldiers or sailors, but the process of selection is a different one. They can continue their arduous toil only so long as their bodily strength remains at its best: and when, from sickness or from advancing age this gives way, they are forced to relinquish their labour. They then either turn to some employment which makes less exacting demands on their energy, or else fall out of the ranks of definite employment entirely, and descend to the sad lot of those who are described as of no settled occupation. It follows, therefore, that the men in actual work in the laborious occupations above mentioned enjoy a special advantage over the workers in less arduous trades; and their mortality, although high in spite of that advantage, appears far lower than it would do if every individual could be traced from the time of his entry on the occupation to the end of life. But what of the men who, after trial of a laborious calling, perhaps for the best years of their lives, are forced by ill-health or other infirmity to relinquish it? Very many of these will be found struggling to eke out a living either as cab-drivers, omnibus guards, or messengers, and being for the most part broken down in health as well as careworn and ill-nourished, they must further increase the already high apparent mortality of these workers. Failing this, they will go to swell the ranks of the classes indefinitely known as costermongers, dock labourers, street sellers, hawkers, and general labourers, or less fortunate still, they will drift into the yet lower grade of the unoccupied, whose terrible mortality I shall shortly have to describe.

The mortality prevailing in a given industry from time to time can only be regarded as, at best, a rough measure of the healthfulness of that industry. The reason for this will be explained presently. It is, however, beyond question that when the public mind becomes sufficiently appreciative of the economic value of human life, and of the wastefulness of ill-health, to demand a registration of sickness corresponding with that which is now in force with regard to mortality, we shall be in a position to measure with a near approach to accuracy the amount of damage done by the several industries to the health and vitality of the workers, although it may not be practicable to suggest in all cases a remedy for the waste and the suffering so caused.

Meantime it is desirable to indicate briefly some of the chief reasons which detract from the value of mortality statistics as criteria of the healthfulness of occupations. And first with regard to the data concerning the living in the various industries. It might seem at first sight a simple matter to sort out the units of an industrial community according to their occupations as stated in the census schedules: but even a superficial study of the experience of those responsible for the conduct of past censuses will show that even this initial process is, in reality, a highly complex and difficult one.

The number of names of more or less distinct avocations in England is enormous; at the last census it was about 12,000, but at the present time it is probably far greater than this. The vast additions that have accrued to our nomenclature of occupations is due in a great measure to the circumstance that new branches of industry have sprung up amongst us in recent years, and that with advancing times, old trade processes have undergone more and more minute subdivision. Nevertheless a large number of more or less obsolete names are still of necessity retained in the list of occupations, for the guidance of the abstractors, although many of those in current use are scarcely more than ephemeral nick-names, which are of but rare occurrence in the schedules.

In recent years the industries of the English people have come to be very minutely subdivided, each group of workers in the several subdivisions being known by a special name; and what is worse, the same name frequently indicates one thing in the north of England, and another thing in the south. Nay, more, it frequently happens that these arbitrary names give no clue whatever to the character of the industry to which they are assigned. Perhaps the most serious and perplexing difficulty met with in connection with classification is the fact that very frequently one and the same name is used to indicate totally dissimilar occupations. Thus, for example, the term joiner in some places is used to designate a carpenter, but in others it means a maker of lace. By clothier is sometimes meant a cloth-maker, in others it stands for a dealer in clothes. By jobber is understood in some cases merely an artisan, whilst in others it takes a more definite meaning in connection with the exchange of money (stockjobber). A drummer is either a soldier or a blacksmith’s striker. A miller is either a dealer in corn or a stone mason. An engineer may be either a maker or a driver of machinery. A placer may be either a potter or an iron manufacturer. In the above-mentioned cases the confusion is only between two occupations, but there are other instances far more numerous and much more troublesome, in which one particular name is used in common for a similar process in a considerable number of different trades. For instance, there are spinners, weavers, warpers, winders, etc., alike in cotton, silk, wool, and flax factories, and when an operative is returned under one or other of these names, without further distinction, it is impossible to decide to which of the several manufactures he ought to be assigned. Nor is the worker necessarily to be blamed for this; for he, failing to see the importance of precision, and perhaps ignorant of the use in other industries of a designation similar to his own, not unnaturally returns himself under some such familiar heading, without further question. Nevertheless it will readily be understood that the existence in the returns of such indefinite headings as “miner,” “labourer,” “artisan,” makes it difficult to estimate the precise number of workers in any industry, if, indeed, it does not in certain cases seriously reduce the value of such estimates. Fortunately, however, the numbers of workers thus vaguely returned at the census are small when compared with the enormously greater aggregates of those employed in the more important industries, and whose exact occupations are definitely known: so that, with respect to these principal industries, at any rate, the numbers can be ascertained with sufficient accuracy for practical purposes.

Thus far a few of the difficulties and possible errors connected with the returns of the living in the several industries having been considered, we now come to speak of the other factor of relative mortality, viz., the deaths occurring in the several occupations, and their classification according to age and probable cause. The difficulties encountered in relation to estimates of population have already been shown to be considerable; and yet they are not only fewer in number, but also less serious than those we shall now have to notice. The vagueness with which occupations are too often stated in the schedules has already been referred to, but unfortunately even greater vagueness is discoverable in the death returns. In proof of this the large group of men, some six hundred thousand in number, who are designated “agricultural labourers,” may be taken as a case in point. In the census returns of the living these men are doubtless correctly described, but in the death registers they are in many cases entered simply as “labourers,” without qualification of any kind. Consequently there is danger lest these men, who for the most part are remarkably healthy, sober, and well-conducted, should be confused with “general labourers,” a sadly unhealthy, degenerate set of men, whose occupation is uncertain, who live from hand to mouth, and whose mortality is nearly double that of agricultural labourers. Coal miners, again, are a class of workers who are likely to be differently entered in the census returns on the one hand, and in the death registers on the other. In consequence of the very commendable efforts which are made to secure accurate returns of the living at each census, it is probable that for the most part miners are classified accurately according to the mineral in which they work, but in the death registers coal miners and iron miners, tin miners and copper miners, are alike in many cases classed simply as “miners,” without further distinction, and thus much uncertainty results as to the exact class of workers to which a particular death should be assigned.

In his Decennial Supplement for the period 1871–80, Dr Ogle dealt with this subject very thoroughly; and inasmuch as his opinion is deserving of great weight, I make no apology for quoting here the following extract from that work. Speaking of the difficulties which occasion flaws in the calculations of occupational mortality, he says:--“There are many trades and occupations which require a considerable standard of muscular strength and vigour to be maintained by those who follow them; such occupations, for instance, as those of a blacksmith, of a miner, and the like; and so soon as from any cause the health and strength of a man fall below this standard, he must of necessity give up the occupation, and either take to some lighter form of labour, or, if his health be too much impaired for this, retire altogether from work. And even in those industries where no excessive amount of muscular strength is required, there must nevertheless be always a certain time beyond which continuance in the business becomes an impossibility. The weaker individuals, and those whose health is failing them, are thus being drafted out of each industrial occupation, and especially out of those which require much vigour; and the consequence is that the death-rates in these latter occupations are unfairly lowered, as compared with the death-rate in occupations of an easier character, and still more, as compared with the death-rates among those persons who are returned as having no occupation at all. A very considerable proportion of those who are forced to give up harder labour take to odd jobs of a more or less indefinite character, and are returned both in the census schedule and eventually in the death registers as general labourers, as messengers, or as costermongers, street sellers, etc.; and thus it comes about that the death-rates of general labourers, of messengers, and of street sellers ... appear to be of appalling magnitude, as also do those of persons returned as of no occupation. Under these headings, however, are comprised the broken-down and the crippled, who have fallen out of the ranks from all the various industries, as well as those who have been throughout life debarred, by natural infirmities or other causes, from following any definite occupation. Another very serious flaw in these death-rates, when taken as measures of the relative healthiness of different industries, is due to the fact that these several industries do not start on equal terms as regards the vitality of those who follow them. A weakling will hardly adopt the trade of a blacksmith, a miner, or a railway navvy, but will preferentially take to some lighter occupation, such as that of a tailor, a weaver, or a shopman. This defect in the death-rate gives an unfair advantage to such industries as demand much strength or activity in those that follow them. Such industries are in fact carried on by a body of comparatively picked men; stronger in the beginning, and maintained at a high level by the continual drafting out of those whose strength falls below the mark.”

In comparing the mortality of occupations at different and perhaps remote periods of time, it is important to ascertain whether any epidemic or pandemic diseases have been seriously prevalent among the general population during either of the periods compared; for in that case considerable allowance will have to be made for this fact, if anything like accuracy of result is aimed at. Thus, for example, in any comparison that may be instituted between the mortality of 1891 and that of 1881, it is necessary to take into account the far-reaching effects of the influenza epidemic which exceptionally and with great severity prevailed throughout the more recent period. It is unquestionable that the fatality of diseases not only of the respiratory but of the nervous and circulatory systems also was seriously increased by this complication, and that the value of any comparison between the mortality statistics of the two periods has been considerably diminished as a consequence.

The foregoing are a few of the more important defects which are unavoidably present in the data from which comparative statistics of occupational mortality are prepared. They are serious and far-reaching. In using such statistics as a means of distinguishing between different industries with respect to their healthfulness, it is necessary to recognise the existence of these defects, and to make suitable allowances for them. Nevertheless when this has been done, it is beyond question that the rates of mortality furnish reliable measures of the healthfulness of different occupations, especially of those in which the number of workers is sufficient to furnish trustworthy rates, and the period of investigation is adequate for the purpose.

Dr Farr has indicated the period of life between the twenty-fifth and the sixty-fifth year as that in which “the influence of profession is most felt.” Dr Ogle, in his Decennial Supplement to the 45th Report, adopted the same view, supporting it by the argument, that in the earlier periods the effect of occupation is not as yet fully developed: and that the last age period (sixty-five and upwards) is that which is more especially affected by the retirement from the industry of such men as have become too weakly to follow it. My own inquiries having tended to confirm these opinions, I have retained in my recent work the same interval, namely, that of the forty years between the twenty-sixth and sixty-sixth birthdays, as marking the period of life during which the effects of occupation are most conspicuous. In the majority of industries this is generally held to be the term of years which most accurately corresponds with the period of man’s greatest capacity for effective labour. There are, however, several occupations in which this is not so. Instances may readily be adduced of occupations in which the actual task of bread-winning both begins and ends at an earlier age than it does in most other industries; so that it would be impossible to specify any limit of age which should apply equally well to all occupations in this respect. Inasmuch, however, as it is necessary for our present purpose to select some one interval for general adoption, the age twenty-five to sixty-five is that which has been adopted as the “main working period of life” in the following pages.

The mortality of any given occupation is influenced very decidedly by “the age and sex distribution” of the workers. The examples following will show how great is this influence: the figures indicate the rates of mortality in each thousand males living in groups of ages: (1) among men in general, (2) among farmers as a class (see table on next page).

From this table it will be seen that the mortality of farmers is below that of males in general at every age-group, and that from the first stage of life to the last it averages from 50 to 60 per cent. of the mortality of males generally. If, however, the total deaths of farmers above fifteen years be calculated on the total number of farmers living above fifteen years, and without further distinction of age, the mortality of farmers would be represented

---------------+---------------+----------+---------------------------+ Ages | General Male | | Mortality of Farmers to | (Years). | Population. | Farmers. | that of Males generally, | | | | the latter taken as 100. | ---------------+---------------+----------+---------------------------+ 15–20 | 4.14 | 1.30 | 31 | 20–25 | 5.55 | 2.40 | 43 | 25–35 | 7.67 | 4.29 | 56 | 35–45 | 13.01 | 7.03 | 54 | 45–55 | 21.37 | 11.20 | 52 | 55–65 | 39.01 | 23.97 | 61 | 65 and upwards | 103.53 | 87.81 | 88 | ---------------+---------------+----------+---------------------------+

by a rate of 19.58 per 1000, or 0.84 per 1000 above that of males in the aggregate. It therefore appears that although farmers do not die so fast as other men at each of the age-groups here specified, nevertheless farmers in the aggregate, i.e., without distinction of age, die faster than other men. This apparent contradiction will, however, be explained when the differences in age constitution are taken into account between farmers on the one hand and males in the aggregate on the other. Reference to the census report will show that there are nearly three-fourths as many farmers above sixty-five years old, when the mortality is 88 per 1000, as there are at ages between twenty-five and fifty-five, when it is only 4½ per 1000: whilst among the male population generally the number living at ages above sixty-five years, when the mortality exceeds 103 per 1000, is less than one-third of the number between twenty-five and thirty-five, when it does not exceed 8 per 1000. From the foregoing example, then, which is by no means a solitary one, it is clear that crude rates of mortality, i.e., rates computed without reference to age differences of population, are untrustworthy as a means of comparing one occupation with another on the score either of health or of longevity.

In dealing with the occupational mortality of 1880–2, Dr Ogle adopted the plan of “deaths in standard population,” which fairly represents the mortality of a given occupation as compared with the general mortality. The same plan has been followed (mutatis mutandis) in the present work. It may be thus explained. The standard population here used is the number of men between the ages of twenty-five and sixty-five years in the population of England and Wales, amongst whom 1000 deaths would occur in a single year; the population in 1891 and the deaths in 1890–2 being taken as the basis. The comparative mortality figure, therefore, is the number of deaths that would occur in a year, according to the death-rates ascertained for a given occupation among 61,215 men of standard age constitution: it represents very fairly the mortality in the given occupation as compared with that among males generally.

Out of 61,215 men aged from twenty-five to sixty-five at the census of 1891 there were enumerated:--

22,586 at the age-group 25–35 years 17,418 „ „ 35–45 „ 12,885 „ „ 45–55 „ and 8,326 „ „ 55–65 „

In order to ascertain the number of deaths that would occur among 61,215 men engaged in a particular industry, all that is necessary is to apply to these four totals the corresponding rates of mortality occurring in that industry: the resulting sum of deaths will be the comparative mortality figure for that industry; and if the calculated deaths in each of the four age-groups be distributed proportionally according to the causes of death in such age-group, the parts of the comparative mortality figure that are due to the several causes will be obtained. By means of the tables which follow in the letterpress, and which have been prepared according to this principle, the mortality of men engaged in the stated occupations may be studied. I now proceed to illustrate, by means of a particular example, the manner in which dissimilar rates may be used for the purpose of comparing the mortality of men engaged in different occupations. In my larger work it was shown that in the three years 1890–2 there occurred among gardeners and nurserymen, between the ages before mentioned, 3462 deaths out of 339,225 years of life. If the age constitution among gardeners had been the same as that among the general English male population, the mortality of 61,215 males taken (1) from among the general male population, and (2) from among gardeners, would stand as follows:--

--------------+-------------------------------+---------------------+ | General Male Population. | Gardeners and | | | Nurserymen. | Age in years. +---------+---------+-----------+-----------+---------+ | Numbers | | Mortality | Mortality | | | Living. | Deaths. | per 1000. | per 1000. | Deaths. | --------------+---------+---------+-----------+-----------+---------+ 25–35 | 22,586 | 173 | 7.67 | 4.14 | 94 | 35–45 | 17,418 | 227 | 13.01 | 6.59 | 115 | 45–55 | 12,885 | 275 | 21.37 | 11.63 | 150 | 55–65 | 8,326 | 325 | 39.01 | 23.29 | 194 | --------------+---------+---------+-----------+-----------+---------+ 25–65 | 61,215 | 1000 | | | 553 | --------------+---------+---------+-----------+-----------+---------+

The true ratio of mortality among gardeners to that among the general male population is thus seen to be 553 to 1000, and this may be expressed by designating 553 the “comparative mortality figure” for gardeners.

Unhealthy Trades.--A simple and rational classification was that of the late Dr Guy, the accomplished physician of King’s College Hospital, by which occupations were divided into (1) indoor, and (2) outdoor. It is matter of common knowledge, at least among medical men, that outdoor occupations are, for the most part, more healthful than indoor; which is tantamount to the statement that a life of labour in the open air, in spite of the danger of exposure to inclement weather, is more conducive to health and longevity than is indoor labour, with its ordinary (though by no means necessary) concomitants of foul air, sedentary habits, and want of exercise.

Having ventured to estimate, with the sole assistance of mortality statistics, the amount of damage to health, as well as of waste of life, which is encountered by workmen of different grades, as a result of their employment, it is of course necessary, in limine, to determine the maladies whose inordinate fatality is to be regarded as evidence that mischief has resulted from any particular trade process. The organs which are affected, not only earliest, but also most seriously, by dusty air and by air which is organically impure, are the lungs: and we naturally look to these organs as being those which will probably exhibit the chief indications of injury. Here, however, we are met by an initial difficulty. Unfortunately, the returns of death, as registered, do not in all cases furnish the means of discriminating between the various kinds of ailment. For example, medical experience shows that under circumstances frequently existing, especially amongst the poor, it is difficult to distinguish accurately between one form of lung disease and another, and there is reason to believe that a considerable number of deaths actually caused by simple inflammatory diseases of the lungs and air passages are erroneously returned in the registers, and consequently in the classified tables, as due to tubercular phthisis. In remote parts of the country, where the populations are for the most part ill-provided with medical attendance, it is the fashion to attribute to what is locally termed “consumption” or “decline,” all cases of illness that are accompanied by cough, expectoration, or shortness of breath. It must, however, be remembered that deaths are not in all cases certified as to cause by medical men: many of them are attested by coroners, and a certain proportion are registered without certificate of any kind. This is exceptionally the case in certain parts of Wales, where the mortality ascribed to phthisis is very high, and where the proportion of persons who die without medical attendance is likewise excessive.

Having regard to the tendency which not infrequently exists to confuse tubercular with non-tubercular affections of the lungs, it is probable that the most reliable evidence derivable from the registers as to the evil effects, on the one hand of irritating atmospheric dust, and on the other of organically contaminated air, will be attained by the adoption of the late Dr Headlam Greenhow’s plan, which was to include the deaths from phthisis under the same heading with those of the respiratory system. This plan has accordingly been adopted here, and in the following tables the order of occupations has been determined by their combined mortality from these diseases. The mortality figures, however, from phthisis as well as those from other lung diseases are separately shown in the tables.

In my larger work on occupational mortality the varying incidence of phthisis and of respiratory diseases among certain classes of workers, in different localities, was treated of in considerable detail. I must here revert somewhat briefly to this subject, in order to explain what follows at a later stage. In the work referred to I showed that among occupied males as a class between the ages of twenty-five and sixty-five the mortality figure from respiratory diseases exceeds that from phthisis by about one-fifth part: among unoccupied males, on the contrary, the mortality from phthisis greatly exceeds that from respiratory diseases. The main causes of this difference are probably: (1) that occupied males who are attacked by phthisis are especially prone to drift into the unoccupied class; and (2) that certain portions of the unoccupied class--the insane, for example--suffer a very high mortality from phthisis. The normally prevailing excess of mortality from respiratory diseases over that from phthisis does not obtain among occupied males in all parts of the country. In the industrial districts that excess is very clearly marked, but London and the agricultural districts are exceptions to the rule, their mortality from phthisis being greater than that from respiratory diseases. In London the mortality from respiratory diseases is high, but that attributed to phthisis is higher still; in the agricultural districts, on the other hand, the mortality ascribed to phthisis is low, but that ascribed to respiratory diseases is still lower. Turning to the separate groups of occupations, it appears that about one-third part of these groups, containing about the same proportion of the occupied male population at ages above fifteen years, differ from occupied males generally, in this respect, that they encounter higher mortality from phthisis than they do from respiratory diseases. This third part of the occupational groups may be arranged in two sections: the first section comprising those occupations which deviate from the general rule because of a special tendency among the workers to succumb to phthisis; the second section comprising those occupations which deviate from the rule for the reason that the workers enjoy unusual immunity from death by respiratory diseases.

The first section may be subdivided thus:--

(a) Occupations which are carried on in close and confined air--commercial clerks, bookbinders, tailors, and tin-miners afford examples of this kind.

(b) Occupations in which excessive mortality from phthisis appears to be associated with alcoholic intemperance--as in the case of law-clerks, inn-servants, and costermongers.

The second section may be subdivided as follows:--

(c) Occupations in which relative immunity from respiratory mortality appears to depend on the circumstance that the workers are protected from inclemency of the weather--instances of this kind are furnished by barristers, school-masters, and domestic servants.

(d) Healthy outdoor occupations characterised by low mortality from both descriptions of lung disease--this sub-section consists of farmers and labourers in agricultural districts, and of gardeners; it is probable, however, that the excess of mortality from phthisis above that from respiratory diseases among these workers is, wholly or in part, only apparent.

The above remarks must be understood to apply only to such occupations as depart from the rule, which is that the mortality from respiratory diseases exceeds that from phthisis. Among the occupations which conform to this rule, there are some in which either impure or dust-laden air is one of the conditions of working; and there are others in which either alcoholic excess or exposure to weather is accompanied by enormous mortality from respiratory diseases. On the other hand, there are also included some occupations in which the workers experience low mortality from respiratory diseases, and still lower mortality from phthisis.

With respect to the standard by which the healthfulness of the several industries is to be determined, only a few words are necessary. The standard should be a high, but for obvious reasons it should be an attainable one, and the men composing it should be of a class not widely different from that of those with whom they are placed in comparison. The men engaged in agricultural pursuits form a group numbering more than a million, and consisting of farmers, graziers, gardeners, and farm labourers. They are for the most part a hard-working and healthy body of men, who spend the greater part of their time in the open air of the country: they may therefore be considered typical of that section of the population which suffers injury in the least degree from the inhalation either of dust-laden air or of air contaminated by organic effluvia. For these reasons agriculturists have been chosen as the class with which the occupations now to be specified shall be compared, so as to render appreciable the serious waste of life which is still experienced by the workers in certain selected occupations.

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X. DUST-PRODUCING OCCUPATIONS

That the constant inhalation of dust as a necessary condition of daily labour results sooner or later in the appearance of grave and characteristic lesions which lead to premature breakdown and death among the workers, is matter of common medical experience. Through the instrumentality of the Factory Department the conditions of labour in these industries have recently been greatly improved: this has been achieved by the general introduction of ventilating fans and of other expedients for preventing the inhalation of irritating particles by the operatives. Nevertheless the returns of mortality still show that several of these occupations produce a terrible amount of suffering and disablement, whilst they unquestionably shorten the lives of those who follow them.

In the subjoined table will be found a list of those industries in which the labourers suffer exceptionally from the presence of dusty particles or other irritating matters in the air of the apartments in which their work is carried on. In this table the mortality of the several dust-producing occupations is contrasted with that of agriculturists, who have been shown to suffer from the effects of dust to a less degree than any other workers. It is not asserted or believed that the whole of the difference between the respiratory mortality of certain unhealthy trades and that of this more favoured class is to be accounted for by dust irritation alone. There are almost certainly present other contributory factors also, the effects of which it would be difficult to show separately: nevertheless, there is no doubt that an atmosphere constantly charged with mechanical impurities of this kind is the main cause of the excessive mortality indicated in the table.

The aggregate death-rate from tubercular phthisis and diseases of the respiratory system is shown in this table, as also are the figures relating to each affection separately. Columns 3 and 4 give the combined mortality from these diseases among the several classes of workers in comparison with that of agriculturists. In the fourth column the mortality of the latter is taken as 100 and that of the other workers is shown proportionally to that figure.

Comparative Mortality from Specified Causes in certain Dusty Occupations.

-------------------+-------------+----------------------+ | |Phthisis and Diseases | | |of Respiratory System.| -------------------+-------------+----------+-----------+ Occupation. | Comparative | | | | Mortality |Mortality | Ratio. | | Figure |Figure. | | |(all Causes).| | | -------------------+-------------+----------+-----------+ Agriculturist | 602 | 221 | 100 | Potter, | | | | Earthenware | | | | manufacturer | 1702 | 1001 | 453 | Cutler | 1516 | 900 | 407 | File-maker | 1810 | 825 | 373 | Glass-maker | 1487 | 740 | 335 | Copper-worker | 1381 | 700 | 317 | Gunsmith | 1228 | 649 | 294 | Iron and Steel | | | | manufacturer | 1301 | 645 | 292 | Zinc-worker | 1198 | 587 | 266 | Stone-quarrier | 1176 | 576 | 261 | Brass-worker | 1088 | 552 | 250 | Chimney sweep | 1311 | 551 | 249 | Lead-worker | 1783 | 545 | 247 | Cotton manufacturer| 1141 | 540 | 244 | Cooper and wood | | | | turner | 1088 | 526 | 238 | Rope-maker | 928 | 486 | 220 | Bricklayer, mason | 1001 | 476 | 215 | Carpet manufacturer| 873 | 471 | 213 | Tin-worker | 994 | 451 | 204 | Wool manufacturer | 991 | 447 | 202 | Locksmith | 925 | 428 | 194 | Blacksmith | 914 | 392 | 177 | Baker, confectioner| 920 | 392 | 177 | -------------------+-------------+----------+-----------+

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2. of Table

-------------------+----------------------------------------- | | Mortality Figure. -------------------+-------------+-------------+------------- Occupation. | | Diseases of | Diseases of | Phthisis. | Respiratory | Circulatory | | System. | System. | | | -------------------+-------------+-------------+------------- Agriculturist | 106 | 115 | 88 Potter, | | | Earthenware | | | manufacturer | 333 | 668 | 227 Cutler | 382 | 518 | 167 File-maker | 402 | 423 | 204 Glass-maker | 295 | 445 | 157 Copper-worker | 294 | 406 | 186 Gunsmith | 324 | 325 | 153 Iron and Steel | | | manufacturer | 195 | 450 | 162 Zinc-worker | 240 | 347 | 126 Stone-quarrier | 269 | 307 | 137 Brass-worker | 279 | 273 | 126 Chimney sweep | 260 | 291 | 142 Lead-worker | 148 | 397 | 272 Cotton manufacturer| 202 | 338 | 152 Cooper and wood | | | turner | 250 | 276 | 137 Rope-maker | 219 | 267 | 118 Bricklayer, mason | 225 | 251 | 130 Carpet manufacturer| 226 | 245 | 87 Tin-worker | 217 | 234 | 124 Wool manufacturer | 191 | 256 | 131 Locksmith | 223 | 205 | 104 Blacksmith | 159 | 233 | 136 Baker, confectioner| 185 | 207 | 130 -------------------+-------------+-------------+---------------

It thus appears that there are 22 industries in each of which the mortality from tubercular phthisis and respiratory diseases together is more than double that of agriculturists; and further, that these 22 occupations include 8 (giving employment to more than 100,000 men) in which the total mortality from these diseases ranges from three times to as much as four and a half times that of the agricultural class.

Potter, Earthenware, China Manufacture.--“The earthenware manufacture is one of the unhealthiest trades in the country. At the age of joining it is low: but the mortality after the age of thirty-five approaches double the average: it is excessively high; it exceeds the mortality of publicans. What can be done to save the men dying so fast in the potteries and engaged in one of our most useful manufactures?” Thus wrote Dr Farr in 1871, with regard to the pottery manufacture of that day. And Dr Ogle, writing ten years later, confirmed this statement, adding that the mortality of these workers at all ages from twenty-five to sixty-five had increased since 1871. He further stated that at that time (namely, in 1881) their comparative mortality figure was no less than 1742, which was only exceeded by the figures for costermongers, Cornish miners, and inn and hotel servants. In the three-year period 1890–92 things had only slightly improved: the mortality in this occupation from all causes remaining almost unchanged; and although phthisis claimed fewer victims than in 1881, lead poisoning had become more than twice as fatal since the previous record, and diseases of the circulatory and urinary systems had seriously increased in fatality. The excessive mortality of these workers is mainly due to phthisis and diseases of the lungs and heart. Of their entire mortality figure (1706) from all causes, not less than 1001 is contributed by phthisis and other diseases of the lungs. The mortality of potters from bronchitis is more than four times as high, and that from other respiratory diseases is three times as high as the mortality of occupied males in the aggregate.

Potters succumb to non-tubercular disease of the lungs much more rapidly than they do to tubercular phthisis; and it is certain that much of the so-called potters’ phthisis ought properly to be termed cirrhosis of the lung. Deaths from this affection should never be included under the head of phthisis, which term is now restricted, by universal consent, to the tubercular malady of that name.

The mortality figure of potters from lead poisoning is 17, and comes next to that of plumbers, as fourth highest in the list of industries liable to plumbism. The mortality figures, due to diseases of the nervous and urinary systems, in these two occupations, exceed the standard for occupied males by 54 and 50 per cent. respectively.

The term “potter” is a very comprehensive one, and is ordinarily understood to mean any workman employed in a pottery. But Dr Arlidge, the author of the best essay of modern times on the ailments of this class of workers, has shown how widely the operations in pottery manufacture differ from one another in their effect upon health. Speaking of the manufacture of earthenware generally he says: “This manufacture stands foremost among those wherein the employment is distinctly chargeable with the production of disease; and the principal materials to which its unenviable character is due are the clays and the flint used in it. However, these minerals are not the only agents that render the fictile trade one so highly injurious to health, for lead also is largely used for glazing and colour-making, and is a frequent cause of plumbism among the artisans. Again, it is a manufacture having many departments, between several of which no common characters can be said to exist. This holds good of the two principal departments, viz., (1) the making of the articles from potter’s clay; and (2) their ornamentation by painting and gilding. They are often spoken of as the “clay” and the “finishing” departments. It is with the former that we are in the first instance concerned, because in it the production of dust ... is pre-eminently the cause of disease.”[43]

Cutlers, Scissors-makers.--The mortality among cutlers is enormous; at all ages it is very high, but at ages beyond thirty-five years it exceeds the standard among occupied males generally by from 64 to 72 per cent. The comparative mortality figure for cutlers at ages from twenty-five to sixty-five years is 1516, which is higher than the average of other occupations by 59 per cent. Cutlers, although in this respect they have an advantage over potters, are nevertheless among the occupations which suffer excessively from “pulmonary” disease. Their mortality figure for phthisis is 382, and for respiratory diseases is 518, against 106 and 115 respectively, the figures for agriculturists. Taking these diseases together, cutlers sustain a mortality in excess of that of other occupations by 122 per cent. It has been shown by Dr Headlam Greenhow and others that the great mortality among cutlers and grinders arises from the irritation caused by the mechanical particles produced during the process of manufacture, and received into the lungs with the air of respiration.

Cutlers suffer slightly from lead poisoning; their mortality from this cause being represented by 3. The occurrence of lead poisoning among cutlers is a novel feature in the mortality returns for 1890–92, Dr Ogle having found no deaths from that cause in the sample of these workers examined by him in preparing his supplement for 1881. In the mortality figures for diseases of the urinary system there is, among cutlers, an excess of 37 per cent. as compared with the standard among occupied males. From diseases of the nervous system the excess of mortality among these workers is 11 per cent. Taking together the mortality ascribed to alcoholism and to liver disease as a rough measure of the mischief caused by intemperance, there is a slight excess among these workers as compared with the standard.

Since the previous record the mortality among cutlers has increased; and this not only at the higher ages, as appears to have been the rule in most other occupations, but also among men under forty-five years of age. Their mortality attributed directly to alcoholism, which had been much below the average in 1881, has risen above the average in 1891, but there has been no corresponding increase under the head of liver diseases. Since the former period the mortality of cutlers from heart disease has increased by 58 per cent., from lung diseases other than phthisis by 38 per cent., and from tubercular phthisis by 9 per cent.

File-cutters.--Judged by their general death-rate, file-cutters are the least healthy men included in our list of occupations, with the exception of publicans (in certain districts) and of dock labourers--their comparative figure being 1810, or three times as high as that of agriculturists. As compared with the standard mortality of occupied males, that of file-cutters is in excess by not less than 90 per cent. At each of the age-groups of the working period of life the mortality among file-cutters is appalling, and this is especially the case at ages above thirty-five years, when the death-rate exceeds the average by from 93 to 110 per cent.

As with cutlers, so with file-cutters--their great mortality appears to depend on the irritation caused by particles of stone or of metal which find their way into the air passages with the respired air. Dr Headlam Greenhow, writing so long ago as 1858, stated that file-cutters owe their enormous mortality from lead poisoning to the circumstance that the files are cut on blocks of lead: their mortality figure for plumbism, in 1890–2, was no less than 75!

Diseases of the urinary system cause a mortality among file-cutters which is above the average by 154 per cent., and diseases of the nervous system a mortality in excess by 159 per cent.

Intemperance does not seem to be especially rife among file-cutters, but they are addicted to suicide in about double the normal proportion.

The comparative mortality figure of file-cutters has increased considerably since 1871: the increase being relatively greatest since 1881. At the age-group 45–65 the increase in the death-rate has been steady throughout the entire period of twenty years, but at ages under forty-five, although between 1871 and 1881 there had been a fall in the death-rate, this has been followed since the latter year by a rise of considerably greater amount.

The mortality from tubercular phthisis, which had been 407 in 1881, has still further increased to 414 in 1891. According to recent experience, file-cutters die from diseases of the circulatory and respiratory systems even more rapidly than they did in 1881.

Glassmakers.--The making, blowing, and engraving of glass occupies a prominent place among unhealthy trades, for several reasons. In the first place, the workers are exposed to extreme variations of temperature--in some processes, that of glassblowing especially, the operatives are constantly exposed to the intense heat of the furnace, as well as to that which radiates from the pots of molten glass which they are engaged in blowing. The intense heat and profuse sweating naturally induce painful thirst, which the workmen evidently allay by excessive drinking: this is shown by the fact that their mortality from alcoholism and from nervous disorders is nearly double that experienced by operatives in other trades. In the next place, glass-makers are subject to plumbism, their mortality figure attributed to this cause being no less than 12, or sixth highest in the list of industries subject to this complaint. According to Dr Arlidge, who has contributed much valuable information on this subject, it is in the cutting and engraving of glass that the operatives are exposed to contact with lead. In these processes “putty powder,” which is a compound of lead and tin, is constantly used, and as the men are careless as to ventilation and cleanliness, often taking their food with unwashed hands, it is easy to understand how lead finds its way into the system.

The comparative mortality figure for glass-makers is 1487, and is, therefore, in excess of the average by 56 per cent. Phthisis and diseases of the respiratory system are especially fatal to workmen in this industry, and they suffer more severely than other occupied males from diseases of the circulatory, digestive, and urinary systems, as well as from cancer. Since 1881 the mortality of glass-workers has increased considerably, and this is true of the younger as well as the older workers in this industry.

Copper-workers.--As the number of operatives engaged in the working of copper is small (scarcely exceeding 8000), only general remarks can be made concerning their health.

At all ages the mortality of copper-workers exceeds that of other occupations; their comparative mortality figure is 1381; it is therefore considerably above that of metal-workers generally, and is also above the standard for occupied males in the aggregate by 45 per cent. That copper-smelting is an injurious occupation is proved by the pallid, sickly appearance of the workers. It has been noticed by Dr Arlidge, as a result of personal experience, that the hair of copper-smelters (especially where this was originally fair or white) becomes much discoloured; but this discoloration is caused, not by absorption of the metal, but simply by adhesion of copper particles to the hair. Nevertheless, he thinks that cupreous salts do eventually find their way into the circulation, and when this is the case the characteristic symptoms of colic, vomiting, and purging with extreme prostration are produced. A greenish or purplish red line is also noticed in the gums, in the same position as that which is occupied by the blue line in cases of lead poisoning. The operations of filing, turning, and polishing of copper are especially injurious to the workmen, and like other dust-inhaling processes, lead to fatal results by interference with the respiratory functions--lung diseases being much more common among these operatives than the average, whilst their mortality from pulmonary phthisis is in excess by 59 per cent. Copper-workers die much more rapidly than other operatives from diseases of the circulatory, digestive, and urinary systems, their mortality from all these forms of disease being greatly in excess of the average among workers in metals generally.

Iron and Steel Workers.--At the census of 1891, more than 200,000 workers in iron and steel, above the age of fifteen years, were enumerated, but the number had decreased since the preceding census by 2 per cent. The labour of iron and steel working is heavy and exhausting. The operatives, whether at the blast furnaces or at the rolling mills, whether puddlers or moulders, are exposed to intense heat, as well as to great vicissitudes of weather, for most of their work is done in the open air, or at any rate in outdoor sheds unprotected from cold and draughts. The men are for the most part sturdy and of powerful build: the arduous nature of their occupation making it impossible for any but the most vigorous to follow it. In spite of these natural advantages, however, statistics show that iron and steel workers are by no means so healthy and long-lived as they ought to be.

The death-rates of these operatives are higher than the corresponding rates among occupied males generally, and also higher than the rates of other metal workers, at all stages of life up to sixty-five years. They have a comparative mortality figure of 1301, which is higher than that of occupied males, as a standard, by 37 per cent. Iron-workers suffer more severely than do other occupied males from influenza and from diseases of the nervous, circulatory, respiratory, digestive, and urinary systems; their mortality figure from diseases of the lungs being more than double the standard figure, and that from phthisis also greatly exceeding the average.

Since 1881 there has been a considerable increase in the mortality of iron and steel workers: the increase has affected both divisions of the working period of life, but has been far the greatest among men over the age of forty-five years.

Zinc-workers.--The number of men engaged in this industry is small, although it has increased by 50 per cent. within the last decennium. Nevertheless, the vital statistics of zinc-workers are important, as showing excessive mortality from all the diseases enumerated in the table on page 135. The evidence is conflicting as to the evolution of noxious matter during the process of extracting zinc from the ore; but the workmen are exposed to great heat, and to the inhalation of irritating particles, in consequence of which they are said to suffer exceptionally from digestive and respiratory troubles. Zinc is coming more and more into use in the process of galvanising sheet-iron, so as to protect it from rust; and in this operation the workmen are exposed to the fumes of sal-ammoniac and to other substances which are said to produce a form of nervous derangement that is apparently peculiar to this process.

Zinc-workers are subject to a mortality considerably above the average. Their comparative mortality figure is 1198, and at ages beyond middle life they die more rapidly than occupied males generally. Their mortality from respiratory diseases and pulmonary consumption together is more than double the standard figure, and they die faster than the average from diseases of the circulatory system.

Lead-workers.--The occupation of lead-working is pursued by but very few in this country; only about 2000 men above the age of fifteen years having been thus returned at the census of 1891, and even this number is rapidly decreasing. But the injurious effects of lead-working are by no means limited to the operatives designated lead-workers in the census returns. In the list of one hundred occupations prepared for my larger work on occupational mortality, not fewer than thirteen were selected as showing unmistakable evidence of plumbism. These occupations are as follows (the figures represent the comparative mortality figures from lead poisoning in the several trades)--

Lead-worker 211 File-maker 75 Plumber 21 Painter and Glazier 18 Potter 17 Glass-maker 12 Copper-worker 8 Coach-maker 7 Gasfitter, Locksmith 6 Lead-maker 5 Printer 3 Cutter 3 Wool manufacturer 3 Occupied males 1

The above occupations are arranged in order according to their mortality from lead poisoning, as shown in the tables. A little consideration, however, will show that these figures represent but very imperfectly the relative damage sustained by the several operatives as a result of their occupations. If, for the sake of example, we compare the mortality figure of lead-workers with that of potters, it would appear, by the table, that the former workers die from plumbism more than twelve times as rapidly as do the latter. But, on closer examination, we find that whilst the whole body of lead-workers are constantly in contact with lead as a necessary condition of labour, not more than a twelfth part of the potters are so circumstanced. It is the dippers and the glost-placers among potters who are the chief, if not the only, serious sufferers from lead poisoning; but as these workers are not distinguished in the census returns from other potters, their deaths are distributed over the whole class of potters, and thus a false impression is conveyed as to the amount of mischief done by absorption of lead, in those branches of the industry where the workers are actually exposed to contact with this metal. Again, when the figures for painters and glaziers are compared with the figure for file-cutters, a great disparity becomes evident; the file-cutters suffering apparently more than four times as severely from plumbism as do the painters and glaziers. But on inquiry, we find that whilst, on the one hand, file-cutters handle lead continuously in the course of their work, on the other hand, painters and glaziers are by no means so constantly exposed to this danger--much of their time being spent on labour which does not involve contact with lead, or inhalation of particles or fumes of that metal. If the death-rates attending those processes in the occupation of potters and of painters which are continuously subject to lead poisoning could be separately ascertained, there is no reason to doubt that they would show results quite as unsatisfactory as those experienced by lead-workers.

Although lead-working is known to be a very unhealthy trade, it is evidently impossible to deduce from the vital statistics of only 2000 workers more than very general conclusions. Speaking generally, however, the mortality returns warrant the statement that, in the main working period of life, these operatives sustain a mortality which is about 90 per cent. above that of other workers, on the average. Their comparative mortality figure from all causes is no less than 1783, and is therefore nearly three times that of agriculturists. Of the total deaths occurring among lead-workers, one-third are from “pulmonary disease,” i.e., from tubercular phthisis and diseases of the respiratory system taken together, and one-eighth are from lead poisoning. As compared with the standard for occupied males, the mortality among lead-workers is excessive from diseases of the urinary, nervous, circulatory, and digestive systems, in addition to the causes above specified.

Stone-Quarriers.--The aggregate of men above the age of fifteen years returned under this heading, at the last census, amounted to nearly 50,000, but the numbers had decreased by about 3 per cent. since the previous enumeration. The comparative mortality figure of quarrymen is 1176, which, as compared with the figure for occupied males, is in excess by 25 per cent. At all stages in the working period of life the death-rate of these labourers exceeds that of other occupations in the aggregate. As stone-quarrying is an outdoor industry, and consequently the workers are not exposed to the unhealthy conditions of sedentary work, the vital statistics of this class should obviously be compared with those of agriculturists, rather than with those of males of all occupations. So compared, we find that stone-quarriers experience a mortality from all causes which is little short of double the standard figure. From respiratory diseases and also from tubercular phthisis, their mortality is at least two and a half times as high as the standard, and from diseases of the circulatory system they die faster than agriculturists by 50 per cent. At ages between twenty-five and forty-five years the mortality of stone-quarriers has fluctuated considerably during the last twenty years; but at ages from forty-five to sixty-five it has steadily increased throughout that period. Since 1881 the increase has been principally under the head of pulmonary and circulatory diseases. During the same interval the mortality of quarriers from phthisis and also from digestive diseases, as well as that from alcoholism and from diseases of the liver, has decreased considerably, and so likewise has their liability to fatal accident.

Brass-workers.--At the 1891 census there were enumerated 33,000 persons over fifteen years of age under the head of brass-workers, braziers, etc., the number having increased since the previous enumeration by little short of one-third.

If death returns alone be relied on, there is little in the mortality of brass-workers that does not apply equally to other allied industries; but from the investigations of Dr Headlam Greenhow in 1858, and more recently those of Dr Simon and Dr Hogben of Birmingham, we learn that brass-workers suffer very seriously from ailments which are not experienced by the workers in copper or in zinc, the chief metals of which brass is an alloy. The disease to which these workers are exceptionally subject is known locally as “brassfounders’ ague,” which, according to Greenhow and some other authorities, is caused by the inhalation of oxide of zinc, whilst others of equal repute attribute it to copper poisoning. That brass-workers are exposed to conditions inimical to health is fully recognised by employers and employed alike, who agree in describing the trade as a most unhealthy one. Dr R. Simon (in a thesis for his degree at Cambridge) says that brass-workers rarely attain old age, and that formerly provident sick societies either altogether refused to enrol them in their lists, or accepted them as members at greatly increased rates. The workers who deal with molten metal--the founders, the mixers, and the casters--are those who are exceptionally liable to “ague.” The “mixers,” who bring together the two metals, suffer most severely. The copper is first molten, and the zinc is then added to it. When the metals come into contact the zinc deflagrates, and some of it, combining with oxygen, flies off in dense white clouds of oxide of zinc. This, of course, is of necessity inhaled by the operatives who, experiencing discomfort from the process, tightness of the chest, and other respiratory troubles, attempt to avoid it by covering the mouth and nostrils with a handkerchief.

Although, as has been previously stated, the deaths registered afford little evidence of the exceptional unhealthiness of brass-workers as compared with the workers in other metals, nevertheless we find that they sustain a mortality from “phthisis” which is in excess of that of “occupied males” by 50 per cent., whilst they die more rapidly than the average from diseases of the nervous, urinary, and respiratory systems. Brass-workers as a class are, like copper-makers, pallid, ill-nourished, and unhealthy-looking: they suffer from anæmia, dyspepsia, constipation, colic, and other digestive troubles. Happily, however, these symptoms do not permanently injure their health, for on changing their occupation, as they commonly do, for a less unhealthy one, the above symptoms rapidly subside, and their usual health is soon restored.

Gunsmiths.--The only remaining metal-workers in the list whose mortality exceeds the average for the class are the gunsmiths. Their comparative mortality figure is 1228, and is exactly 100 in excess of that of metal workers in the aggregate. Gunsmiths die faster than the average of metal-workers at ages from twenty-five to forty-five, but less rapidly both before and after that period of life.

On reference to the extended tables in my larger work, it will be found that gunsmiths die from alcoholism about two and a half times as fast as do other workers in metal. Most of the processes in which gunsmiths engage are of an unhealthy nature, and the workers are exposed to the harmful effects of metallic and flinty dusts which set up in the lungs very similar disorders to those which have been noticed in connection with the Sheffield “grinding” trades. This industry demands expert workmanship and high finish, especially in the later processes, and involves a great deal of filing and polishing of metal, and these operations are frequently carried on in workshops which are ill-ventilated and otherwise unsuited for the purpose. As a consequence, the mortality of gunsmiths from phthisis (much of which is probably fibroid) stands at 324 against 206, the figure for metal-workers generally, and 185, the standard figure for all occupied males. From other diseases of the respiratory system and from diseases of the heart, gunsmiths sustain a mortality which exceeds the standard for occupied males by 47, and by 21 per cent., respectively. During the last twenty years, and especially during the more recent half of that period, the mortality of gunsmiths has increased considerably, and this is true whether we consider their mortality during the earlier or during the later half of the main working period of life.

Chimney Sweeps, Soot Merchants.--Recent statistics agree with those of earlier records in attributing to this industry a very unsatisfactory position in the scale of health. Compared with those of other occupations, the death-rates of chimney sweeps are excessive at all ages below the sixty-fifth year. Their comparative mortality figure amounts to 1311, and is therefore higher than the standard by more than one-third part.

Chimney sweeps are, by the nature of their calling, much exposed to the inhalation of particles of soot and of other irritating matters which seriously affect the respiratory functions. They die more rapidly than the average from pulmonary tuberculosis, and from other diseases of the lungs, as well as from diseases of the heart and urinary organs. Their mortality from suicide is also more than double the average, and their figure for intemperance is more than four and a half times that of occupied males generally. But it is in regard to their extreme liability to malignant disease that chimney sweeps are deserving of special consideration. Their mortality from different forms of cancer amounts to 156 as compared with 44, the figure for occupied males in the aggregate. In the list on p. 135 there is no other occupation in which the ravages of cancer at all approach those to which chimney sweeps are subject. Of the 512 deaths from all causes among chimney sweeps, as many as 61, or about 1 in 8, were from cancer, and 18 of the 61 were returned as from chimney sweeps’ cancer. Of these 61 deaths 3 were ascribed to sarcoma, and the rest to carcinoma or other forms of malignant disease. In the course of the last twenty years the mortality of these workers has decreased considerably. Between 1871 and 1881 their mortality figure, modified for purposes of comparison, had fallen by 11 per cent., the fall in the death-rate having been common to both divisions of the main working period of life, but much greater at ages under than at ages over forty-five years. In the interval between the two last censuses, on the contrary, the fall has been greater at ages above forty-five years. Although chimney sweeps still die from cancer in enormous over-proportion, there has happily been a great abatement in their fatality from this disease since the previous record. In 1880–82 the mortality figure had been 290, whilst in 1890–92 the figure, modified to allow of comparison, was 157, showing a reduction of nearly half within that interval.

Textile workers.--In the accompanying list there still remain several dust-producing occupations in which the mortality from pulmonary diseases is in excess of the average, notwithstanding that the workers are not exposed to the action of metallic irritants. Of these there are four which may be taken to represent the textile trades--viz., the manufacture of cotton, wool, rope, and carpets--in all of which the mortality figure from respiratory diseases is not only vastly in excess of the figure for agriculturists, but is also considerably above that of other occupied males. Among textile workers, cotton operatives (especially those of Lancashire) are the most unhealthy. Their mortality figure from all causes is higher than that of occupied males generally, by from 20 to 23[A] per cent., whilst from diseases of the respiratory system exclusive of phthisis, their mortality is in excess by proportions varying from 53 to 65[44] per cent. The workers in cotton mills suffer severely from the presence, in the air, of “fluff” and “flue” that escapes from the cotton, especially in the preparation of the yarn. The amount of this and the degree of irritation to which it gives rise when inspired, varies with the quality of the material used; inferior and brittle cotton, being more liable to breakage in the course of manufacture, gives off more dust than do the finer kinds, and requires for its successful working a warmer and moister air. The workers in the lower-class cottons therefore suffer more seriously in health, and require more perfect arrangements for ventilation than do those who deal with materials of higher quality. Cotton spinners have to work all the year round in a very warm and humid atmosphere, and accordingly suffer from debility and exhaustion caused by profuse sweating. The temperature and moisture of the sheds are maintained at a high standard both night and day, in order to prevent brittleness in the cotton fibres, and as a consequence the operatives become peculiarly sensitive to chills, brought about, perhaps, by injudicious exposure to draughts. From personal experience in Manchester, for a period of twenty-five years, I can testify that these workers are exceptionally liable to acute rheumatism, and this statement may be confirmed by reference to the mortality tables in my larger work, which show that the mortality of cotton spinners from this disease exceeds the average by not less than 70 per cent. The operation of “sizing,” preparatory to the weaving of cotton, introduces a new element of danger. The size contains, in addition to flour or farina, a very large proportion of china clay, which finds its way into the air passages, and there produces its well-known mischief. It is pleasant to record that cotton operatives do not add to the evils of their occupation by undue recourse to alcohol: their mortality from intemperance being below the average by 23 per cent.

Wool, Worsted Manufacturers.--Wool-workers suffer much less severely from their occupation than do cotton operatives. In the weaving of woollen materials, a lower and drier temperature is required than in the case of cotton-weaving, and the mischief caused by “sizing” with china clay and other irritants has no place in woollen manufacture. Nevertheless, in certain of the processes, especially where inferior foreign wools are manufactured, a good deal of dust is disengaged, and this produces its ill-effect on the lungs of the workers. It is also in connection with dirty or blood-stained foreign wools that the majority of cases of anthrax or wool-sorters’ disease have been observed from time to time, which have been the subject of inquiry in past years by the Medical Department of the Local Government Board.

It is worthy of notice that wool-sorters are even more careless as regards exposure to cold and draughts than are even cotton workers, and their mortality from rheumatic fever is much higher, being double that experienced by agriculturists as a class. Wool-workers have a comparative mortality figure from all causes, which is somewhat above the average for occupied males generally, but is below that of other textile trades. Workers in wool appear to be remarkably free from intemperance, their mortality figure being less than one-fourth of the average. From diseases of the digestive system other than the liver, wool-workers die half as fast again as do occupied males generally, whilst from diseases of the nervous, respiratory, and urinary systems, as well as from cancer, the mortality of these workers is from 10 to 22 per cent. in excess of that standard.

Other Workers in Dusty Trades.--The accompanying list includes a few industries, the workers in which have not yet been alluded to as regards their health: such as the rope-makers, carpet-makers, coopers, bricklayers, bakers, etc. These industries, although not remarkable for the production of other serious forms of illness, have this feature in common, that being essentially dust-producing processes, they one and all induce among the workers excessive suffering from pulmonary affections. Although the mortality of these workers from phthisis and other lung diseases is considerably below that of metal-workers, nevertheless it is in every case inordinately high, exceeding the mortality of agriculturists by proportions varying from 77 to 120 per cent.

EFFECTS OF BREATHING FOUL AIR.

In my larger work on occupational mortality, detailed vital statistics are given respecting those workers whose occupation is not in itself necessarily unhealthy, but who are the victims of unwholesome conditions of labour, either self-inflicted, or else caused by the ignorance or the parsimony of persons in authority. The evils here alluded to are the result partly of the accumulation of respiratory and other impurities in the air breathed, from neglect of suitable methods of ventilation, and partly of the cramped posture adopted in certain cases (notably by tailors and shoemakers) in their sedentary indoor labour. Considerations of space preclude the insertion here of a complete list of these occupations; but in the following table a selection has been made of those industries in which the workers are liable, in the greatest degree, to damage from the inhalation of foul air in the course of their employment. For each of these occupations the figures indicating the mortality from phthisis and from diseases of the respiratory and circulatory systems are separately shown, and in another column the combined mortality of the several occupations from the first two of these forms of disease is compared with that of agriculturists, the latter being taken as 100. The occupations have been arranged in the descending order of their mortality from tubercular phthisis and respiratory diseases together.

Comparative Mortality from several causes in certain unhealthy occupations.

+----------------+---------------+-----------------------+ | | | Phthisis and Diseases | | | Comparative | of | | | Mortality | Respiratory Organs. | | Occupation. | Figure +------------+----------+ | | (all Causes). | Mortality | Ratio. | | | | Figure. | | +----------------+---------------+------------+----------+ |Agriculturists | 602 | 221 | 100 | | | | | | |Bookbinder | 1060 | 543 | 246 | |Printer | 1096 | 540 | 244 | |Musician | 1214 | 522 | 236 | |Hatter | 1109 | 511 | 231 | |Hairdresser | 1099 | 489 | 221 | |Tailor | 989 | 466 | 211 | |Draper | 1014 | 441 | 200 | |Shoemaker | 920 | 437 | 198 | +----------------+---------------+------------+----------+

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+----------------+---------------------------------------+ | | | | | Mortality Figure. | | | | | Occupation. |-----------+-------------+-------------+ | | Phthisis. | Respiratory | Circulatory | | | | Diseases. | Diseases. | +----------------+-----------+-------------+-------------+ |Agriculturists | 106 | 115 | 88 | | | | | | |Bookbinder | 325 | 218 | 115 | |Printer | 326 | 214 | 133 | |Musician | 322 | 200 | 191 | |Hatter | 301 | 210 | 141 | |Hairdresser | 276 | 213 | 179 | |Tailor | 271 | 195 | 121 | |Draper | 260 | 181 | 135 | |Shoemaker | 256 | 181 | 121 | +----------------+-----------+-------------+-------------+

From this table it will be seen that, roughly speaking, the combined mortality from phthisis and respiratory diseases varies from twice to two and a half times that of agriculturists. It may further be stated (although the figures are not given in the table) that the workers in four of the above-mentioned occupations die from these diseases alone more rapidly than farmers in the agricultural districts die from all causes put together. Contrary to the experience of two-thirds of the occupied male population of England and Wales, tubercular phthisis is more fatal than are diseases of the respiratory organs other than phthisis, to all the workers in the table, except agriculturists.

Bookbinders, Printers.--Writing in 1881 of the sanitary condition of these workers, Dr Ogle speaks of both of them in common as “carrying on their industries under notoriously unhealthy conditions, in ill-ventilated rooms, and in an atmosphere unduly heated by engines, stoves, and flaring gas-lights.” The decline in the death-rates, as compared with the earlier records, he attributes to the improvements effected by the Factory Inspectors since these trades came under their supervision. Further on he writes, with respect to their mortality: “Excepting costermongers ... and those industries in which the workman is exposed to the inhalation of dusts, such as file-makers, potters, and Cornish miners, there is no industry in the table in which the mortality from phthisis approaches to that of printers.” “As for bookbinders,” he writes, “so far as can be judged from the 77 deaths of which the causes are recorded, in this industry also the high mortality is due to phthisis, for of the 77 deaths no less than 30 were caused by this disease.”[45]

In both of these trades the conditions of work have still further improved under the supervision of H.M. Factory Inspectors since the above was written. Taking bookbinders first--The returns show that their death-rates are still considerably above those of agriculturists, and, indeed, above those of other occupied males at most of the ages in the working period of life, their comparative mortality figure being above the firstnamed standard by 76 per cent. Bookbinders still die very rapidly from pulmonary consumption, their mortality figure from that disease being no less than 325, or more than three times as high as that of agriculturists. Their mortality from cancer and from diseases of the respiratory, circulatory, and urinary systems also shows excess. Bookbinders are more addicted to suicide than are agriculturists, in the proportion of 26 to 10. Ever since 1871 the mortality of bookbinders has steadily decreased, and there has been a fall in the death-rates at ages under as well as above the forty-fifth year.

Printers experience a death-rate at the various age-groups which is above the standard at all the age-groups dealt with in the table. Their mortality figure is 1096, as against 953 for all occupied males, and 602 for agriculturists. Like bookbinders, printers die very rapidly from phthisis, and probably for a similar reason--namely, because of the excessively unhealthy conditions under which their work is carried on--their mortality from diseases of the respiratory organs other than phthisis is, however, below the average, but from diseases of the nervous, circulatory, digestive, and urinary systems it is above the average. Printers suffer only about one-third as much from fatal accident as do other workers, but they are somewhat more addicted to suicide. Their mortality figure from lead poisoning is represented by 3. In the course of the last twenty years the mortality of printers from all causes together has decreased considerably. Both the age divisions in the main work time of life have shared in the fall, but in unequal proportions. As compared with that of 1881, the mortality of these workers from alcoholism in 1891 has fully trebled, and that from suicide has more than doubled. The most important decrease occurs in the case of phthisis, the mortality from which has fallen, since 1891, by one-sixth part of the former rate.

Musicians.--The mortality of the class of men who, by a euphemism, are styled “musicians,” is very high. At all ages in the working period of life it greatly exceeds that of agriculturists, and also exceeds that of the working population in the aggregate. Their comparative mortality figure amounts to 1214, or more than double the figure for agriculturists, and is about one-third part in excess of that of occupied males generally. Compared with both these standards, musicians die more rapidly from alcoholism and from diseases of the liver. Their mortality figure from phthisis is enormous, amounting to not less than 322, or fully three times that of agriculturists, and almost double that of male workers in the aggregate.

In addition to the above, musicians sustain very heavy mortality from diseases of the nervous, circulatory, digestive, and urinary systems, and their mortality figure from suicide is 23, as compared with 10 for agriculturists and 14 for other occupied males. From these statistics it is certain that many of those who are included in this class are sadly addicted to intemperance, whilst others suffer from want of the bare necessaries of life. “It must be remembered,” writes Dr Ogle in 1881, with reference to the mortality of this class, “that under this heading are comprised all sorts and conditions of men, and that a large portion of them are organ-grinders, ballad-singers, and street musicians generally, many of whom are of intemperate habits, and exposed by their mode of life to cold and want, while no few have merely taken to the occupation as a refuge, after their health has broken down in more regular occupations.”

Within the last twenty years the mortality of musicians has declined very considerably, both at the earlier and at the later ages. Their comparative mortality figure in 1891 was lower than it had been in 1871 by more than one-fifth part: nevertheless, their vital statistics still continue to be very unsatisfactory, and their nomadic habits are a serious hindrance to improvement.

Hatters.--As compared with agriculturists, the mortality of hatters is enormously greater at all stages of the working period of life, and their comparative mortality figure from all causes is in excess of that standard by 84 per cent. At ages under thirty-five years, hatters experience a death-rate which barely exceeds the average among occupied males, but at each subsequent age-group their mortality is greatly in excess. As far as we know there is little in the employment of hat-makers which of necessity acts prejudicially to their health. Their work, however, like that of too many other trades, is frequently carried on in overcrowded and ill-ventilated apartments, and the men suffer accordingly. Thus we find from the tables that hatters die from tubercular phthisis about three times as rapidly as do agriculturists, and that their mortality from this complaint considerably exceeds the average in other occupations. Hatters appear to be much addicted to intemperance, their mortality figure from alcoholism, and also from liver disease, showing serious excess. Their mortality from suicide stands at 28, as compared with 10 for agriculturists and 14 for other occupied males. Among hatters under the age of forty-five years there has been a decline in mortality within the last twenty years, but at ages from forty-five to sixty-five there has been but little change.

Hairdressers.--The mortality of hairdressers is higher than that of other occupied males at each of the age-groups of the working period; it is, consequently, greatly in excess of that of agriculturists. Their mortality figure from all causes at ages twenty-five to sixty-five is 1099, and, therefore, exceeds that of the standard last mentioned by 82 per cent. The life of a hair-dresser is for the most part a town, or at least a village, life; the work being carried on indoors for long hours together, in an atmosphere heated and polluted by gas. In addition to this, the occupation is a dusty one, and the men are exposed to the effects of particles of hair and other irritants which find their way into the lungs. Their mortality figure from alcoholism, liver diseases, and gout, as well as from pulmonary tuberculosis, shows serious excess; it therefore appears that hairdressers, as was the case in 1881 also, are still excessively addicted to intemperance. They fall victims to suicide almost as rapidly as do even the least fortunate workers included in the list of occupations. Hairdressers experienced almost the same rate of general mortality at the census periods of 1871 and 1881, but since the latter year there has been a fall in their mortality to the extent of about one-seventh part.

Tailors.--The occupation of tailors is a typically sedentary one. The men work for the most part in overcrowded, ill-ventilated, and overheated rooms, and consequently suffer in general physique and appearance, as well as in health. In recent years the introduction of machinery, whilst in some respects an advantage, has produced its counterbalancing ill-effects by rendering it possible for any man or woman who can work a sewing machine to take the place of the regularly skilled tailor, and thus to depreciate the market value of his labour. In consequence of this the tailor and his family are only too frequently reduced to great poverty, if not to a state approaching starvation. The mortality of tailors at the several age-groups does not greatly differ from that of other occupied males. Tailors die more rapidly than agriculturists at ages between twenty-five and sixty-five, but at ages below and above these limits their mortality does not greatly exceed this standard.

Although in past times tailors have been considered an intemperate class, the figures for 1890–92 lend little support to that opinion. Their mortality figure from alcoholism as well as from liver disease scarcely differs from that of occupied males generally, although, of course, it considerably exceeds the low figure of agriculturists.

The mortality of tailors from tubercular phthisis is greatly in excess of that of other occupied males, and is more than two and a half times as high as the mortality of agriculturists; it is also worth mention that they die more rapidly than other workers from diseases of the nervous system. On the other hand their mortality from influenza and from diseases of the respiratory organs, and of the heart, is in each case below the average. During the last twenty years there has been a notable increase in the mortality of tailors at ages from forty-five to sixty-five years, and an equally notable decrease at ages from twenty-five to forty-five. Although the mortality directly ascribed to alcoholism is now slightly higher than it was in 1881, nevertheless the mortality from diseases of the liver and other digestive organs has undergone a more than equivalent reduction, so that the total mischief caused by intemperance has probably decreased since 1881. The mortality of tailors from gout as well as from phthisis, and from diseases of the nervous system, has fallen since the same year.

Drapers, Manchester Warehousemen.--The large body of men included under this heading appear to enjoy but poor health, when allowance is made for the fact that the greater part of them are under twenty-five years of age. Drapers and Manchester warehousemen, who are here grouped together because of the similarity of their occupation and mode of life, are credited with a mortality which is higher than that of any other occupation save one in the category of shopkeepers. Their comparative mortality figure from all causes is 1014, which, as compared with that of agriculturists, is in excess by 68 per cent. Even when compared with the low standard of “occupied males,” drapers are subject to a mortality which is considerably above the average. Confinement in close, ill-ventilated shops for very long hours together, and an almost exclusively indoor life, is the unlucky fate of these workers. They are exposed to the heat and fumes of gas and cotton “fluff” and dust which escapes from the bales of goods in process of sale, and their health suffers accordingly. Their death-rate from tubercular phthisis exceeds that of other occupations by not less than 41 per cent., and is more than two and a half times as high as that of agriculturists; but the fact previously mentioned, that drapers’ assistants are for the most part youths or young men, may account to some extent for their exceptional liability to this scourge. Drapers die faster than the average from influenza, rheumatic fever, and diabetes, as well as from alcoholism, diseases of the liver and nervous system, and from suicide. During the main working period of life, the mortality of drapers has decreased somewhat since the earliest record. In the first twenty years of this period, i.e., from twenty-five to forty-five years of age, their death-rate has fallen considerably since 1871; whilst at ages from forty-five to sixty-five years, although it had fallen between 1871 and 1881, it has since returned to its former level. Since 1881 the mortality of drapers from all causes has increased by 18 per cent. Between 1881 and 1891 their mortality from phthisis remained stationary, whilst that from other lung disease and heart disease showed a considerable increase. Their mortality from suicide has increased threefold since 1881, and that from alcoholism has increased by nearly two-thirds.

Shoemakers.--Although the contrary is generally held to be the fact, shoemakers are shown by the figures now at our disposal to enjoy a degree of health which is at least equal to that of the average working man.

As the occupation of shoemaking is an indoor one, involving sedentary labour for many hours together, in closely confined and ill-ventilated apartments, the workers suffer inordinately from those ailments which are commonly associated with such environment. Up to the thirty-fifth year of age shoemakers die faster than other occupied males, but more slowly at later ages. Compared with agriculturists the mortality of shoemakers at all ages is in excess by 53 per cent.

Shoemakers die much less rapidly than the average from lung diseases (except phthisis) as well as from accident, and their mortality from intemperance is remarkably low. Cancer and pulmonary consumption, however, play sad havoc among shoemakers, their mortality from the first-mentioned disease being in excess of the average by 14 per cent., and from the last-mentioned, by 38 per cent. Throughout the three decennia, commencing with 1861, the mortality of shoemakers above the age of forty-five years has steadily increased, whilst below that age it has steadily decreased; the balance showing a slight increase in the total mortality figure. Under the head of alcoholism their mortality has increased since the earlier record, although that from liver disease has decreased. Shoemakers die as rapidly as ever from pulmonary consumption, and more rapidly than ever from diseases of the lungs and heart. Their mortality from diseases of the nervous system has, however, shown a decided improvement, and they are at the present time less addicted to suicide than was formerly the case.

THE MINING INDUSTRY.

At the census of 1891 more than half a million men above the age of fifteen years were returned as miners, their number having increased since the previous census by more than a fourth part. As the proportion is still probably increasing, we may safely calculate that at the present time one in every 17 males between the ages of twenty-five and sixty-five years is a miner. In round numbers it may be stated that of the 524,000 miners in England and Wales, 482,000 work in coal, 18,000 in ironstone, 9000 in tin, 6000 in lead, 2000 in other minerals, and 1000 in copper; whilst the remaining 6000 are classed under the head of “mine service.” With a few noteworthy exceptions, miners are not, as a whole, an unhealthy body of men, but from the nature of their employment they are necessarily more exposed than are other workers to certain forms of violent death. The various groups of miners, however, have, of course, this feature in common, that most of their time, for a great part of their life, is spent underground. Accordingly their work is carried on under conditions of heat, moisture, etc., which are exceptionally artificial, and for this reason it is desirable that their mortality should be studied with especial care. The following table shows the death-rates of miners at several ages, compared with the corresponding rates of occupied males. The figures in each column represent proportions of the standard figure, the latter taken in each case at 100.

+-------------------------------+----+----+----+----+----+----+-------+ | | 15 | 20 | 25 | 35 | 45 |55 | 65 and| | | | | | | | |upwards| +-------------------------------+----+----+----+----+----+----+-------+ | Occupied Males. |100 |100 |100 |100 |100 |100 | 100 | | | | | | | | | | |Mining Industry |148 |112 | 87 | 78 | 95 |121 | 147 | | | | | | | | | | |Coal miner |150 |111 | 86 | 77 | 94 |119 | 143 | |C M {Durham and Northumberland |154 |111 | 75 | 66 | 79 | 97 | 152 | |o i {Lancashire |163 |107 | 88 | 94 |110 |140 | 150 | |a n {West Riding |115 | 92 | 76 | 77 | 89 |126 | 138 | |l e {Derby and Notts | 93 | 68 | 69 | 59 | 73 | 96 | 118 | | r {Staffordshire | 95 |109 | 82 | 70 | 95 |135 | 180 | | s {Monmouth and Wales |227 |141 |118 | 97 |117 |140 | 129 | |Ironstone miner |134 | 90 | 82 | 66 | 83 | 91 | 144 | |Copper miner |... |158 |129 |146 |118 |127 | 170 | |Tin miner |116 |139 |111 |115 |161 |180 | 178 | |Lead miner |118 |127 |130 |109 |116 |182 | 240 | |Mine service |127 |264 |129 | 98 | 95 |113 | 155 | +-------------------------------+----+----+----+----+----+----+-------+

The table shows that at ages from fifteen to twenty, and from twenty to twenty-five, as well as at both the age-groups above fifty-five years, miners in the aggregate die more rapidly than do other occupied males, whilst at intervening ages they die less rapidly. Miners, however, are a picked class of men in a more especial sense than are the toilers in most other industries. Their labour is so arduous that those only who possess exceptional physical endurance are able to continue it, and this may account for the fact that when they are barely past the prime of life many of them become enfeebled, and subject to a mortality which is considerably in excess of that incidental to other occupations.

On attempting to trace the causes of mortality in the various groups of miners, and to compare those industries, in this respect, with one another and with other occupations, it readily appears that a large, though very inconstant, proportion of the total mortality is contributed by “accident.” It is accordingly desirable to isolate this factor, so that we may arrive at a fair judgment as to the loss of life by disease alone occurring amongst these workers in their several fields of labour. This has been done in the following table, where the comparative mortality of the various groups of miners is given (a) from all causes except accident, (b) from certain prevalent diseases, (c) from accident or violence, and (d) from disease and accident together.

+---------------------------+-------------------+-------------+ | | All Causes | Alcoholism. | | | except Accidents. | | +---------------------------+-------------------+-------------+ | =Mining Industry= | =800= | =4= | | Coal miners | 784 | 4 | | Durham & Northumberland | 678 | 5 | | Lancashire | 914 | 5 | | West Riding | 798 | 4 | | Derby and Notts | 638 | 2 | | Staffordshire | 817 | 2 | | Monmouth and Wales | 902 | 7 | | Ironstone miners | 688 | 4 | | Copper miners | 1195 | | | Tin miners | 1361 | 4 | | Lead miners | 1267 | 5 | | Mine service | 946 | 6 | | Farm labourer | 590 | 4 | | Occupied males | 897 | 13 | +---------------------------+-------------------+-------------+

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+---------------------------+-----------+-----------+-------------+ | | Liver | Phthisis. | Respiratory | | | Diseases. | | Diseases. | +---------------------------+-----------+-----------+-------------+ | =Mining Industry= | =18= | =109= | =267= | | Coal miners | 17 | 97 | 269 | | Durham & Northumberland | 23 | 94 | 156 | | Lancashire | 17 | 102 | 389 | | West Riding | 16 | 123 | 288 | | Derby and Notts | 18 | 69 | 159 | | Staffordshire | 8 | 83 | 319 | | Monmouth and Wales | 16 | 107 | 345 | | Ironstone miners | 20 | 90 | 204 | | Copper miners | 28 | 331 | 347 | | Tin miners | 28 | 508 | 377 | | Lead miners | 34 | 380 | 325 | | Mine service | 42 | 114 | 216 | | Farm labourer | 13 | 115 | 129 | | Occupied males | 27 | 185 | 221 | +---------------------------+-----------+-----------+-------------+

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