122

THE LANCET.

LONDON: SATURDAY, AUGUST 6, 1853.

INFLUENCE OF OCCUPATION ON HEALTH.

IF with respect to most things " prevention is better thancure," it is pre-eminently so in relation to disease and physicalsuffering. This we have endeavoured to illustrate in several

late leading observations. Appealing more particularly, aswe do, to the purely professional branches of society, we haveever kept in mind how important an influence we might fairlybe supposed to exert upon the general community by address-ing it occasionally upon subjects connected with publichygiene-subjects easily comprehended (in their broader

characters at least) without requiring a technical education.These remarks are not alone confined to the knowledge of theprofession, but meet the eyes of a very large and general bodyof readers. The letter of Mr. SPONG (THE LANCET, June 11)proves that such observations may yet be extended with

advantage. It must not be forgotten that although the avoca-tions of milliners and dress-makers are often fraught withmischief, yet other trades and social duties likewise tend tostamp upon their followers the impress of their deleterious

influences, or to cause in them the manifestations of particularforms of disease. Now some of these injurious influences

appear to be quite remediable, others partly so, whilst some, itmust be admitted, seem to be inseparable from the particularcalling. Whatever walk of life or labour a man may follow,(and nearly all must follow something,) it can never be divestedof certain effects upon the system-effects special to the par-ticular avocation or characteristic of the class to which it

belongs, will sooner or later evince themselves. There maybe a wide difference between the duties of a littémteur and coal-

heaver, a linen-draper’s shopman and manufacturer of white-lead, nevertheless the difference does not free such persons fromthe common liability of being influenced by the peculiaritiesof their calling. As might be expected, there is of course

great difference between the influences thus exerted, some

being very great and highly deleterious, other slighter or lessevident, or if not so, still less fatal in their effects ; for it doesnot follow that because there is less general sickness in aspecial trade there shall be a lower rate of mortality; or, on

the other hand, because there is a high rate of mortality in itthere shall be so much as the average rate of sickness. For

example, according to the investigations of Mr. NEisoN, (VitalStatistics, &c.,) bakers, at the early and middle periods of life,are less subject to sickness but to a higher rate of mortality,whilst butchers experience a very high rate of mortality, butnothing above the usual amount of sickness; whilst with

labourers, colliers, miners, engine-drivers, &c., accidents and

injuries kill healthy men in a minute, the sedentary life, thefoul, over-heated air, long monotonous hours of employment,anxiety, and emotional excitement attendant upon the avoca-tions of a clerk, compositor, and tailor in a 11 great metropolis,"or upon livelihoods earned in the courts and cellars of Liver-

pool and London, produce no sudden deaths, but sadly diminishthe average expectation of life, causing a gradual, but earlydecrepitude. It too often happens that unless what is hurtfulexhibits very salient features, we are sceptical;of its force.

This is a great error-‘° Gutta cavat lapidem non vi sed seepe cadendo."

It cannot be denied, it is true, that " dry-grinding," andthe preparation of needles, razor-blades, and fork-prongs,are, under any circumstances, highly deleterious occupations.When not performed under the funnel and revolving fan, orwith other contrivances to collect and carry off the minute

metallic and gritty particles loading the atmosphere, they arefearfully and quickly Loethal, killing the workman in a fewyears. But, on the other hand, we cannot help believing that ascene-shifter, a carpenter at a theatre, a waiter at a night-tavern, &c., breathing so habitually an atmosphere loaded withhalf-consumed gas, port fires, and human halitus, or tobacco

smoke, and the evaporations from different dishes, spirituousliquids, &c., (and this too for hours after they should be atrest or asleep,) must be severely impressed by very unhealthyeffects. Again, there is very much difference between theavocations of a fashionable lady and a hard-working cobbler,and yet both frequently suffer from affections of the respiratoryorgans, heart, and stomach, and a particular form of dyspepsia,from a not very dissimilar cause. In the former this is the

compression of the thorax and its contained and adjacentviscera by tight-lacing, whilst in the latter it is the constantpressure of the last &c. against the sternum, combined with-the stooping or bent position whilst thus at work. The ladyand her laundress also exhibit like effects from much the same

causes. With the former, a season spent in over-heated, un·ventilated, crowded ball-rooms, is productive of menorrhagia,leucorrhoea, fashionable pallidity, &c., on the one hand, and"a very bad cold" on the other, caught by the sudden tran-sition from the hot air inside to the cold night air outside thehouse of amusement; while, visit the hot, stifling, unventilatedironing-room of the laundress, with its (perhaps red-hot)ironing stove, heated by charcoal, in the centre, and examinethe pale-faced, flabby woman working there, and it will befound that menorrhagia, leucorrhoea, sudden catarrh, and

hoarseness, or complete aphonia, are the diseases of the place.What greater difference apparently in the duties of the sailorsin a " crack" frigate, and the men of a " crack" company ofhorse artillery, and yet the manoeuvring of both producesmuch the like results. Examine the pulse of the sailor beforehe has gone aloft to reef a topsail, in obedience to the ordersof some strict disciplinarian or martinet. Examine it againwhen lie comes below: it is, perhaps, twenty beats quicker inthe minute. Feel the pulse of the artilleryman before unlim-bering and limbering his gun. There is a like difference in its

pulsations. And what is the consequence ? We believe, the

production of aneurisms, of- diseases of the heart and largevessels. Deleterious results produced by the absurd demandsfor very rapid exertion in too short a time for its safe per-

formance, by which congestion of important internal organsensues, and not from the labour itself being too excessive.We have heard of a captain who always made it a rule to

flog the man that lay last upon the yard, thus brutally andignorantly warring against a physical necessity.

It has been maintained by some, that most of the evils at-tendant upon the following of indoor employments of a hurtfulcharacter have their origin in the constant and unintermittingsubjection of the employed to the depressing elements makingup the " great town system," rather than to circumstancesessentially connected with the particular avocation. That

123THE AMENDED VACCINATION BILL.

much evil has its origin in this way we do not deny, but weagree with Mr. NElSON so far as being incapable of compre-hending how the plumber, the painter, and the glazier, are tobe relieved from the poison of the metallic emanations theymust necessarily be subjected to in their trade, by any im-proved sewerage, draining, or planning of streets. It is true

ventilation will carry off bad air, and bring fresh in its place,and public baths and wash-houses will offer means for personalcleanliness, which will diminish the liability to the absorptionof poisonous particles, kept otherwise in contact with the

surface. Nevertheless, with all these appliances of prevention,workers with lead, with mercurial amalgams, lucifer-matchdippers, and batters of cotton will betray some special effectsof their calling as surely as the man of intellect the thoughtupon his brow. But if some evils are thus inseparable fromour duties it by no means follows that we must put up with allthose which at the present moment are thus associated, anymore than it is necessary that milliners and dress-makers are

to be forced to work in the dead of night, propped up by thestimulation of green tea, simply because we can never hope tobestow upon them the ruddy hue of health so frequently anattendant upon the out-of-door duties of the Welsh milkmaid

WE have been favoured with a sight of the VaccinationExtension Bill, as amended in Committee, (ordered by theHouse of Commons to be printed July 25, 1853.) As there is

no little probability of this Bill becoming part of the law ofthe land without any further amendments, its provisions willbe examined with anxiety by the profession. It presentsseveral improvements on the Bill " as amended on re-commit-ment" by the House of Lords. These are chiefly:-1. Thatthe trivial and vexatious directions about the method of vac-cination are omitted; and no medical man is required tovaccinate " without fee or reward."-(Sect. 1.) 2. Provision

is made for inspection on the eighth day after vaccination.-(Sect. 3.) This is a very important improvement. 3. A

minimum fee for the public vaccination is fixed-viz., eighteen-pence within two miles, and half-a-crown beyond that distance.This is too little, but it is an instalment which shows that a

sense of justice adorns some honourable members of the Houseof Commons.-(Sect. 6.) There are also some alterations for

the worse. The House of Lords had provided that neglectof vaccination should be punished by repeated and increasingpenalties. But the Committee of the Commons have providedonly one penalty not exceeding twenty shillings." It c-

mains to be shown whether this one penalty will be sufficientto secure universal vaccination.

The profession will be much annoyed and disgusted at per-ceiving that two principles are still vitiating the Bill, whichwill always grate injuriously on its machinery, and verymaterially impede its working. 1. The principle of placingthe vaccination of the nation in the hands of the Poor-law

guardians, who neither understand the subject, nor are likely,as a whole, to concur cordially in the requirements of theBill. 2. The principle, at once insufferably unjust, and neverto be tolerated, of compelling medical men to do strictly pro-fessional work without fee or reward. This flagrant andindecent violation of our rights as citizens and as men, appearsin two of the provisions of the Bill. Sect. 4 provides, that onthe successful vaccination of any child by any medical man,

the vaccinator shall give to the parent a certificate, accordingto a prescribed form, to the effect, that the said child has beensuccessfully vaccinated, and shall also transmit a duplicate ofthe said certificate to the Registrar of Births and Deaths of thesub-district in which the operation has been performed. Thiscertificate and its duplicate are to be extorted without feeor reward. And yet this very document is the only pro-tection the parent will have (in case of information) againstthe penalty.Again, with still greater injustice, if possible, Sect. 5 pro-vides, that if any medical practitioner shall be of opinion thatany child is not in a fit state for vaccination, " he shall there-

"upon and immediately deliver, without fee or reward, to the" father and mother of such child," &c., a certificate accordingto a prescribed form, to the effect, that the child is in an unfitstate for vaccination; and this certificate he is required torenew every two months, until the child becomes in a fit state

t for vaccination, be it ten months or ten years. In a case of

scrofulous, syphilitic, cutaneous, or other constitutional disease,which might render vaccination improper or impossible, con-

tinuing, say for ten years, the medical attendant would be

required by this odious law to give one hundred and twentycertificates without fee or reward! / Really this is worse than

being required to vaccinate for nothing. It is preposterous.But what a wretched piece of legislation is this, which, by itspalpable injustice, defeats its own intentions! Let it pass.It will serve to show that if the nation is to be vaccinated, thelegislature must condescend to ask the profession how it is tobe done. The Vaccination Committee has offered to supplythe House of Commons with every requisite information, andthe House has availed itself of some important hints; othershave been rejected, and the Bill is consequently lame. Weshall watch its dodgings, and describe them.

A GLEAM of common sense has suddenly shot across theminds of the promoters of the new Lunacy Bills. In the

discussion on Wednesday night in the House of Commons,Mr. MITCHELL, having moved an amendment affecting theprivate asylums, was followed by Mr. DRUMMOND, who said," he was so fully persuaded of the importance of the public"being made aware of the nature of private asylums, that he"requested the House not to attempt to do anything with"the present Bill at that time of the session. It was his

" intention early next session to move for a committee of

"inquiry into the private asylums (hear, hear), for he wasperfectly certain there were many persons confined im-properly, and that it was the rich who suffered rather than"the poor." Mr. WALPOLE, the conductor of the Bill, ob-served, "that no one could say this Bill was not a great11 improvement on the law, but the proposed amendment" would introduce new principles, involving considerations ofI a most difficult and delicate nature, which could only bediscussed with much fuller information than they had at" present."What is this but an admission that these Bills, which

profess to consolidate the entire legislation relating to

lunacy, are urged on in the absence of sufficient informationon the subject, and therefore in the face of the certain dangerof their operating in the most mischievous manner i We

have omitted no opportunity of insisting on this point, and it

124

is with some satisfaction that we find this truth at length, andbefore it is yet too late, making its way in the House ofCommons. It is true that Mr. MircnEH/s motion was with

drawn; but the immediate progress of the Bill was arrested

by Sir JAMES GRAHAM, who moved that the Chairman reportprogress, as there were several very important Bills on thepaper to be advanced a stage.

It is earnestly to be hoped that Mr. WALPOLE will profit bythe interval thus afforded him, and allow the conviction

which has so tardily struck him, that he is not sufficientlyinformed upon this subject, to make a still deeper and more Iwholesome impression upon his mind.

WE believe we are correct in stating that Lord PAUMRSTONhas, for the present session at least, abandoned all idea

of proceeding’ with the proposed new Charter for the Col-lege of Plysicians. That the pretensions of the Collegehave met with less sympathy on the part of the body of theprofession, and that there has been far less unanimity on thesubject than the Home Secretary was at first led to believe,is certain. Hence, no doubt, the conclusion he has arrivedat. Should the College determine to renew this attempt atextending their corporate powers another year, they will dowell to exhibit a more liberal courtesy towards the professionin general, and a franker spirit of conciliation in meeting thejust claims of other institutions.

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ON the 2nd instant Mr. HEYwooD moved for leave to bringin his Bill for the abolition of religious tests preparatory tomatriculation and graduation at Oxford and Cambridge. TheChancellor of the Exchequer expressed a hope that the hon.member would not press his’ motion. The motion was then

withdrawn. Such is the report of the proceedings_ in theHouse of Commons in reference to this ill-timed and ill-

advised measure. Was it worth while to assert a noble prin--ciple in such a manner, at such a time, and with the pre-meditated resolve to submit to so lame and impotent a con-clusion ! We have on a former occasion set forth the reasons

which induced us to regard Mr. HEYWooD’s Bill as a measure. calculated to complicate and retard the great cause of free

education ; we have now only to record our satisfaction at theresult of his ill-judged attempt.

THE MEDICAL BENEVOLENT FUND. - At the lastmeeting of the committee, held July 26th, letters of acknow-ledgment of the sums granted at the previous meeting havingbeen read, the treasurer announced that the balance due tohim was 4l. 10s._ Cases: 1. The widow ofa medical man now ata training establishment, to enable her to become a school-mistress, so that she may support her family. She has beenrelieved several times previously. Recommended by Mr.Newnham and Mr. Toynbee. Voted 10l. 2. An orphan of amedical man, who died leaving four children; she has beenin an orphan asylum, but has not been re-elected to completeher education. The sum of 901. is required to secure her re-election, towards which a grant of 10l. was voted. Recom-mended by Dr. Bernand and Dr. Rogers. 3. The widow of amedical man, who died lately at sea when in charge of anemigrant ship. He left five chddren wholly unprovided for,the eldest of whom is only five. years old..A policy of in-surance for 1001. was forfeited from some informality. Re-commended by Mr. 1. B. Brown, Mr. Brown, of Hammer-smith, and Mr. Toynbee. Voted 10l. 4. The widow of aphysician, who practised in London, and who died lately,leaving seven children. Recommended by Professor Fergus-son and Mr. Toynbee. Voted 20/ ; lot. to be given now, and10A in January. 5. The widow of a medical man in distress.Voted 5l.

THE

ANALYTICAL SANITARYCOMMISSION.

RECORDS OF THE RESULTS OF

MICROSCOPICAL AND CHEMICAL ANALYSESOF THE

SOLIDS AND FLUIDS

CONSUMED BY ALL CLASSES OF THE PUBLIC.

11 To attack vice in the abstract, without attacking persons, may be safe

lighting indeed, but it is fighting with shadows."

TOBACCO,AND ITS

ADULTERATIONS.(Continued from page 107.)

IN the report published last week we enumerated the’ different species from which the several varieties of tobacco

are obtained, described the cultivation of the tobacco plantin Virginia, gave the minute structure of the leaves, their

, chemical composition and properties, the processes by whichraw or unmanufactured is converted into manufactured

tobacco, and, lastly, we described the different varieties of cutand roll tobacco; these particulars were necessary in orderthat the subject of the adulteration of tobacco might be themore easily and fully comprehended.On referring to Act 5 and 6 Vict., entitled, "An Act to

amend an Act of the fourth year of her present Majesty, todiscontinue the Excise survey on tobacco, and to provideother regulations in lieu thereof," (10th August, 1842,) we findthe following provisions relating to the adulteration oftobacco:-By Clause 1 it is enacted, ’‘ that no manufacturer of tobacco, shall, in manufacturing any tobacco, make use therewith of

any other material, or any other liquid substance, or matter,or thing, than water only; or in manufacturing any snuff,make use therewith of any other material, or any other liquid,or substance, or matter, or thing, than water, or water andsalt, or alkaline salts only, or lime water, in snuff known as

Welcla or Irish snuf," under a penalty of three hundredpounds.Clause 2 allows of the use of essential oils for scenting and

favouring snuffs, as also oil in making up spun or roll tobacco.By Clause 3 it is provided, "that any manufacturer of,

dealer in, or retailer of tobacco, who shall receive, or takeinto, or have in his possession, or shall sell, send out, or

deliver, any tobacco or sijuff which shall have been manu-factured with, or shall have had added thereto, or mixedtherewith, any other substance than water, shall forfeit twohundred pounds."Clause 4 declares all tobacco manufactured otherwise than

with water, or the other substances allowed by law, as oil inthe making up of roll tohacco, or salt, or alkaline salts, orlime water, in snuffs, to be forfeited.

By Clause 5 it is enacted, " That no manufacturer of tobaccoshall receive, or take into, or have in his possession, any sugar,treacle, molasses, or honey, (except for the necessary andordinary use of his family,) nor any commings or roots of malt,or any ground or unground roasted grain, ground or ungroundchicory, lime, sand (not being tobacco-sand), umber, ochre, orother earths, sea-weed, ground wood, moss, or weeds, or any

leaves, or any herbs or plants (not being tobacco leaves orplants) respectively, nor any substance, syrup, liquid, or pre-paration or thing, to be used or capable of being used as asubstitute for, or to increase the weight of, tobacco or snuff,on pain of forfeiting the same and two hundred pounds." ,

Clause 6 provides that manufacturers of tobacco who arealso grocers may carry on the two trades or businessesin separate premises. It states, "It shall be lawtul for theCommissioners of Excise to authorise and empower suchperson to carry on the business of a manufacturer of tobacco,without being subject to the same penalty by reason of having