Repetitive strain injury may be a modern phenomenon. But, as Peter Homan reports, our Victorian forebears had their own occupational diseases to cope with
Repetitive strain injury and backache are ailments that may be contracted during employment. But how many occupations have actually given their names to particular medical conditions? At the end of the 19th century many such names were in frequent use and some continue to be used today.
Victorian repetitive strain injuries included Typewriter's, Telegraphist's and Writer's Cramp. Musicians might suffer Pianist's Cramp in the fingers. Each was due to the repeated way of working with the hands in a set position. Repeated strain on other parts of the body could also cause problems. Most common was probably Housemaid's Knee - inflammation of the bursa in front of the patella - from floor scrubbing in the kneeling position.
Miners' Elbow was caused by the miner leaning on one elbow while using the other arm and Miner's Back, a type of lumbago, was also caused by working in the cramped conditions of a mine shaft. Because of constantly straining to look upward at the roof, a miner could develop Miner's Nystagmus, a condition where the eyes make rapid, uncontrolled movements that become faster as the condition worsens.
Professional sportsmen may develop Tennis Elbow or Golfer's Elbow, the first affecting the outer part and the second the inner part of the elbow. Weaver's Bottom developed from sitting on a hard bench for long periods, causing bursitis and abscesses at the base of the spine.
Miners had other problems. Coal Miner's Phthisis (or Anthracosis) was a condition of black lung caused by the inhalation of coal dust. While not life-threatening, it gave rise to catarrhal coughs.
Tunnelling where high air pressure was required to stop water penetration could cause Caisson Disease, the same condition as Diver's Paralysis (also called "the bends"), which results in paralysis in the limbs owing to air in the bloodstream. A caisson was a device for working on the bed of a river or where excavations were carried out in water-bearing soil. It was a large cylinder, closed at the top and open at the bottom. Compressed air was pumped in to a pressure equal to the water pressure enabling work to continue in dry conditions.
Tunnel Disease was an anaemic condition caused by the parasitic hookworm, Ankylostoma duodenale (also known as the tunnel-worm). Hookworm was also responsible for Brickmaker's Anaemia, the parasite being present in the brick-making materials.
Diseases of the lung owing to inhalation of particles included Potter's Disease (or Potter's Rot or Potter's Asthma), with symptoms resembling emphysema, caused by inhalation of dust that was brushed off china after it had been fired.
Loss of hearing and, in extreme cases, bursting of the eardrums was a consequence of Boilermaker's Deafness due to the long-continued effect of loud noises.
The eyes might have suffered from the effects of heat and glare of the furnace causing Glassworker's and Ironworker's Cataract.
What did Hatter's Disease and Barometer Maker's Disease have in common? Both resulted from the use of mercury. Rabbit skins, used in hat making, were treated with mercuric nitrate and mercury was used in barometers. Inhalation of mercury vapour caused salivation, ulceration of the gums and tremor or shaking.
Brass is an alloy of zinc and copper and, when the molten alloy is poured into moulds, dense fumes of zinc oxide are produced which, when inhaled, could induce Brassfounder's Ague. Symptoms included malaise and throat irritation, followed by headache, nausea, muscle pains and high temperature.
Painter's Colic was lead poisoning that produced a blue line on the gums at the roots of the teeth, abdominal pain, constipation and nausea.
Dermatitis of the skin gave rise to many conditions, including Baker's Itch from sugar, Grocer's Itch from sugar and washing soda, Bricklayer's Itch and Plasterer's Itch from lime particles, Millstone and Quarry Cutter's Rash from stone particles, Barman and Waiter's Rash from beer and wine dregs, Photographer's Rash from chemicals, Glass-paper Maker's Rash, Galvaniser's Eczema, Tarworker's Rash, and many more.
Chimney Sweep's Cancer was the name given to cancer of the scrotum. It was quite common among chimney sweeps and was a condition caused by soot. It was also named Gardener's Cancer from the practice of spreading soot on to gardens and allotments. Owing to the moisture and humidity of that region of the body, particles collected readily, acting as chronic irritants. Scrotal cancer was also known as Spinner's Cancer, prevalent among mule-spinners in the cotton trade. This was due to the friction of the machine's faller bar against the weaver's oil-saturated clothing.
One of the most life-threatening diseases was from the textile industry. Known as Textile Worker's Disease, Wool Sorter's Disease or Rag Sorter's Disease, it was anthrax (Bacillus anthracis). Contracted by inhalation of spores or by swallowing spore-containing dust residual in woollen products, it can produce pneumonia. Contact with the skin can produce severe ulceration known as malignant pustule.
A career in the church had its problems. Clergyman's Throat (or Clergyman's Sore Throat) was a slowly developing condition which, due to constant use of the voice, caused inflammation of the throat and impairment of speech. It was a condition shared with schoolteachers and street hawkers.
Sign up for the army and you could develop Soldier's Heart, a name given during the American Civil War to a group of symptoms, including breathlessness on exertion or emotion, pain over the area of the heart, palpitation and exhaustion. The condition was also recognised in the 1914-18 war.
A visit to a barber's shop might result in an attack of Barber's Rash, ringworm of the beard (Tinea barbae), passed from person to person via an unsterilised shaving brush.
Giving up work for a life of leisure was not the answer. You might develop Smoker's Throat, Smoker's Heart, Gin Drinker's Liver (sclerosis) or even Vagabond's Disease (infestation with body lice, Pediculosis corporis).
If you lived a life of crime you might end up with Jail Fever (typhus) from poor conditions of hygiene in the prison.
The Workmen's Compensation Act of 1906 placed a heavy liability on employers who were engaged in dangerous trades for any disablement of their employees by disease incidental to and arising out of their occupation. It included anthrax, poisoning by lead, mercury, phosphorus or arsenic and ankylostomiasis (hookworm). Amendments over the years plus new legislation such as the Health and Safety at Work etc Act 1974, which includes the Control of Substances Hazardous to Health (COSHH) Regulations (SI 1989 No 1657), have greatly reduced the numbers of work-related medical conditions.
To date I have not found any occupational diseases directly relevant to pharmacy but perhaps it might happen - how about Apothecary's Apoplexy, or Pharmacist's Fatigue?
Peter Homan is a retired community pharmacist and honorary secretary of the British Society for the History of Pharmacy