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Thomas Hodgkin
(17 Aug 1798 - 5 Apr 1866)
English physician and philanthropist who was the most prominent British pathologist of his time and a pioneer in preventive medicine. As a social activist, he advocated the freeing of slaves and an end to the exploitation of child labour.
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Remarks on Occupational Health
by Thomas Hodgkin
extract from a lecture (c.1830)
[In this extract, Hodgkin demonstrates his early insights for occupational health at a time approaching two centuries ago. We might claim to be appalled by the environmental conditions and disregard for workers' health of that era, until we consider the child labour and sweat-shop clothing factories that so sadly remain in various less-developed parts of the world, and where protections of law are inadequate. Hodgkin laments that in his time, the consumers of fashion supported and encouraged the evil inhumanity of such manufacturing regimes. Such concern sadly still rings as true nearly two centuries later.]
[p.250] I shall now [describe effects on health due to] the influence of particular occupations: but in doing so, I shall not confine myself to the effects produced on the muscles, or moving apparatus, but rather take this opportunity for offering whatever observations may suggest themselves respecting the injurious tendency of particular modes of employment, let the organ or function which is disturbed be what it may.
I have already noticed the peculiarities observable in the size and vigour of the limbs of boatmen, coachmen, and smiths, induced by the unequal allotment of exertion and rest which their different muscles receive. Some occupations are injurious to health, by reason of the position which they require. Shoemakers, weavers, and turners, are examples of this. I have frequently noticed the fact in shoemakers. From the position in which they sit at their work, the chest is distorted, and the stomach pressed upon. Pain in the lower part of the chest, indigestion, symptomatic headache, and sickly countenance, are the consequences, and the action of the bowels is apt to be irregular and sluggish. [p.251] A careful combination of exercise with work, and attention to diet, would tend much to counteract the evil;—but I must take this opportunity of recommending a reform in the position in which shoemakers work. I have proved, in practice, that this may be managed, for at least a part of their work, by their imitating the method of sewing adopted by saddlers. In general, I must confess that I have found the shoemakers too much disposed to continue their pernicious position.
My attendance on the patients of the London Dispensary convinced me that weavers are liable to pain of chest, accompanied with indigestion, forming a complaint very similar to that of shoemakers. The cause, I suspect, is nearly the same; namely, an habitual bad position of body, too much bent forwards, and attended with constant pressure against the chest.
Other occupations are pernicious, from their being attended with exposure to noxious vapours or other poisonous agents; as in mining, and in smelting of ores, in which process the vapour of arsenic is often disengaged. Painters suffer from the poison of lead; which is the cause of our frequently finding them with paralyzed wrists, called “the painters’ drop.” Another disease, to which they are very liable from the same poison, is “the painters’ colic,” a disease attended with much pain and danger. Gilders, and those who are employed in silvering looking-glasses, suffer from the poison of quicksilver, which is used in the operation.
Those who are engaged in manufacturing the various articles into which tobacco is converted often have their health impaired by the poisonous properties of the plant. I have heard that something similar [p.252] is observable amongst those who are much employed in tea-warehouses, and especially with the dust of green teas.
Some trades expose those who are engaged in them to injury, not so much from the poisonous properties of the materials with which they are employed, as from the form in which they act on the system; as, for example, when the substances are reduced to a very fine powder, which may affect the health by entering the air-passages with the air which we breathe, or by applying itself to the surface of the body and destroying the functions of the skin. Of this description are various kinds of grinding: thus, needle and knife grinders are liable to inhale the fine dust arising from their grindstones, in which are intermixed some extremely small particles of metal. The effect of this exposure is, to give rise to disease of the lungs. It is a slow and lingering complaint, by which the patient is in most cases carried off: it is called the grinders’ rot. Although the particles of iron appear to be those on which the mischief mainly depends, this must be ascribed to their form, rather than to any pernicious chemical property; since iron, not without reason, is regarded a wholesome metal. In consequence of the fatal effect of this disease, attempts have been made to prevent the inhalation of the particles of iron; and a plan proposed by my late friend, Hall Overend, of Sheffield, appears completely to answer this purpose. It consists in placing magnets in such situations that they may attract the particles of iron, and not allow them to enter the mouth or nose. Notwithstanding the dreadful fatality of the grinders’ rot, and the happy result of the ingenious contrivance which has been devised to counteract it, it is to be [p.253] feared that many grinders continue the old and unprotected practice of the trade. Glass-cutters, and those masons who are engaged in working some kinds of stone which produce much dust, are liable to serious and fatal disease of the lungs, from a similar cause. Some of the processes through which cotton and hemp must pass in the course of manufacture, expose those who are engaged in them to an atmosphere charged with fine floating particles, to a degree which often renders it insupportable to the unaccustomed, even for a few minutes. Some of these evils have been fully proved on evidence before the Committee of the House of Commons, on M. T. Sadler’s Factory Bill. The injurious effects of dust on the lungs might, in many instances, be very much obviated by the work-people wearing thin gauze veils whilst they are exposed to it; a plan which has been successfully adopted in some factories. Those whose occupations oblige them to remain in an atmosphere charged with extremely active and even poisonous particles, as is often the case in chemists’ laboratories, find an effectual protection in breathing through a mass of light cotton wool, tied before the face, so as to secure the mouth and nose.
Bakers and millers afford examples of fine powders acting on the skin. Bakers’ itch, and other eruptions, are the consequences to which may be frequently added an impaired state of the general health. Bakers, however, are exposed to other causes; which, as they probably have more influence than the flour in disturbing the health, will induce me to return to the consideration of this class of tradesmen.
There is no occupation in which the person is so constantly and generally exposed to the influence of a [p.254] fine and subtle dust or powder as in the case of sweeps; but the miseries which attend the abominable practice of employing climbing-boys are so numerous, so various, and so grievous, that it would be difficult to refer to each the amount of its share of destructive influence. Not only does the general application of the soot to the surface of the body interrupt the natural functions of the skin, but it tends to produce a very serious ulcerating disease in parts of the body which are exposed to friction. As this disease is evidently the effect of soot, it is called chimney-sweepers’ cancer. Other ill effects of the soot, to which sweeps are exposed, are not so apparent; but it is probable that the soot has some share in producing the stunted growth, the distorted limbs, and general weakness, so commonly observed amongst this unfortunate class.— I cannot allude to this subject without saying something more respecting it, since the practice of employing climbing-boys to sweep our narrow flues, charged with coal-soot, is a crying evil, which, as long as it exists among us, is a foul stain to our age and country. The humanity of our countrymen has, with success as well as reason, been appealed to in behalf of the oppressed African, torn from his friends and dragged into slavery, subjected to the horrors of the middle-passage, exposed to the indignities of the slave-market, and doomed, through a period of hopeless slavery, to toil and hardships, greater and more destructive to life than those to which our worst criminals are condemned, when transported for life: but I think that we are inconsistent with ourselves, and wanting in our duty, so long as we withhold our deepest sympathy, and our strenuous assistance, from the suffering and helpless class of climbing sweeps, on [p.255] whom are too often inflicted the combined miseries of the slave-ship and the terrors of the slave-driver. The sufferings which they undergo in this metropolis, peopled as it is with those whose benevolence, extending beyond the limits of our own country, reaches to the most distant spots of the globe, would seem fabulous, were they not incontestably proved, and daily taking place, almost under our own eyes. The wretched children who, in their tender years, are sacrificed to this horrible employment require the same fostering care as other children of the same age; but, victims of profligate parents, or kidnapped by inhuman wretches, they are doomed to pass through a short life of filth, and of misery in every shape, including cold, hunger, nakedness, disease, and depravity of mind. Besides the chimney-sweepers’ cancer, which is not apt to shew itself in very young persons, sweeps are at times subject to a very exaggerated form of rickets, to softening of the bones, and to a great tendency to fractures. Whilst it is the object of the laws to protect the innocent from the encroachments of the guilty, and to impose restraints on the perpetrators of violence and injustice, it surely ought not to be regarded as an unwarrantable extension of the power which makes and executes the laws, to suppress this signal enormity, and espouse the cause of the unfortunate infants who have neither power nor influence to effect any thing in their own defence.
Some trades and occupations are injurious to health, in consequence of the extremes of heat or cold, or of the rapid changes of temperature to which those who follow them are exposed. Glass-blowers, and those who are engaged in many of the processes connected with the working of metals, are subjected to a degree [p.256] of heat which, without great care and prudence, cannot fail to be injurious to health, and even destructive of life. The points to which they should be particularly attentive, are, First, duly to regulate their daily work; in order, if possible, to avoid being confined to it for many hours in succession at one period; whilst at another they may scarcely keep up the habit of enduring it, or even expose themselves to an opposite extreme. Secondly, to pay attention to the functions of the skin, that perspiration may not at one time be excessive, and be stopped at another; and that it may not be allowed to accumulate on the skin, intermixed with filth and dirt. To obviate this, the habitual practice of bathing, washing, or sponging the whole body, as the peculiar circumstances of the health and employment of the individual will point out, is of great importance. Thirdly, they should pay particular attention to the rules respecting eating and drinking, which I have laid down in my former Lecture; and, as great heat has a necessary tendency to produce thirst, they should be more particularly on their guard to avoid excess in drinking. The quantity taken, even of water and other diluents, should be as small as possible. It must, of course, be somewhat greater than the quantity taken by persons who are not exposed to inordinate heat; but if they drink much more freely, they promote excessive perspiration, which will not only increase the tendency to thirst, but prove very debilitating, as well as favour their proneness to injury from its suppression. It has been proved that the purest spring-water is the best beverage which these persons can employ. Fermented liquors, and more especially ardent spirits, are decidedly injurious. Their inferiority to pure water has been shewn by [p.257] actual experiment. The disadvantage of gratifying thirst whilst exposed to a high temperature is felt by persons in hot climates, and more especially by those who traverse the hot and parched deserts of Africa; who learn, like their camels, to resist the calls of thirst, except at the stated intervals devoted to meals and rest. The case of our countrymen confined in the Black Hole at Calcutta, which I related in my First Lecture, forcibly illustrates the impropriety of gratifying thirst, when persons are crowded in heated apartments.
Bakers are another class of persons whose occupation exposes them to an injurious and long-continued high temperature; and although the degree of heat, to which they are subjected, is not so excessive as in the case of the trades and manufactures of which I have before spoken, its effects are combined with several other injurious influences. They have to perform their labour at unseasonable hours, by which their rest is shortened and disturbed; they are constantly exposed to fine dust over their bodies, the effect of which I have already noticed; they often work in confined and ill-ventilated apartments; and breathe an atmosphere charged with the vapour arising from new bread, which not only contains a considerable quantity of spirit, which it is now in contemplation to save, but also a disagreeable empyreumatic oil, and a small quantity of sulphuric aether, the production of which can only be accounted for by attributing it to the alum introduced into the bread. Instead of counteracting, by prudent and careful management, these evils, some of which are inseparable from their trade, they too often immensely aggravate them by an intemperate and dissolute course of [p.258] life, which is unhappily so prevalent as to affix a general reproach on this useful and very necessary class of men. There are few trades, the unhealthy tendency of which is more apparent, in the complexion and countenances of those engaged in it, than in the case of bakers; whose pale faces form a striking contrast with those of butchers, whose employment, although laborious, is of a much more healthy character.
Exposure to a high degree of heat in confined apartments constitutes one of the evils to which those are exposed who attend the spinning-mills in cotton-manufactories, and more especially in those in which fine thread is made, since such a temperature appears to be indispensable to the proper working of the material. Though this can scarcely be urged as a proof of inhumanity on the part of the manufacturer, who is obliged to accommodate his articles to the prevailing taste of the market, yet it is a strong argument in favour of those salutary restrictions which tend to reduce the evil to its lowest degree, and to divest it of needless superadded aggravations;—restrictions which entitle M. T. Sadler and Lord Ashley, whose zealous exertions have led to their adoption, to the lasting praise of the community. The wearers and consumers of those articles, which, from the fineness of their quality, place the children and others engaged in manufacturing them under the necessity of enduring a pernicious degree of heat, would do well to reflect how far they are justified in supporting and encouraging the evil.
There is another class of individuals, whose health is very often exposed to serious injury from the occupation in which they are engaged: I allude to the girls employed by milliners and dress-makers. I am [p.259] aware that the temperature in which they live forms but a part, and perhaps only a small part, of the evils to which they are subjected; yet I cannot mention them more suitably than in connexion with the factory-children, in order that they may share in that kind sympathy which has been so generally and warmly excited in behalf of that class. The evils to which the dress-makers are exposed are very numerous, and generally operate at a time of life in which attention to health is particularly necessary and important. They are often confined to their working apartments, in which several individuals are crowded together in the unhealthful and painful position which needlework requires, during a larger portion of the twenty-four hours than any other class of work-people are required to devote, with short intervals for meals, and none for relaxation. They frequently commence their work at six in the morning, and sometimes much earlier; and are obliged to continue it till a late hour of the night, sometimes beyond midnight. I need not tell you that they become debilitated, relaxed, and sickly. This general effect you may have observed for yourselves. They are peculiarly liable to obstinate and painful indigestion; to distressing hysteric affections; to liver complaints; to pain, especially of the side, generally extremely obstinate, and often very severe. They are subject also to glandular swellings; and to a painful affection of the legs, which frequently terminates in distressing sores. Some of the most trying and untractable cases of debility in females which I have ever witnessed, have occurred in persons of this class. They furnish, I believe, a larger proportion than almost any other class of young women in this country, to the awful number annually cut off [p.260] by pulmonary consumption. In addition to these serious evils affecting the bodily health, there are others no less important, which influence their habits in life and their moral character. They are utterly cut off from the means of acquiring domestic habits, and deprived of the opportunity of becoming acquainted with domestic pursuits. They acquire a pernicious taste for finery, which the miserable pittance which they earn is insufficient to gratify. They make an appearance in the world which, whilst it removes them from commiseration, increases the number and magnitude of their temptations, and prepares them to join those whose ways lead to the gates of death.
- 17 Aug - short biography, births, deaths and events on date of Hodgkin's birth.
- Thomas Hodgkin: Morbid Anatomist & Social Activist, by Louis Rosenfeld. - book suggestion.
