Children's Employment Commission 1842

Extracted from the report by R F Franks to the Children's Employment Commission on the East of Scotland District which was published in 1842

On the Diseases, Conditions, and Habits of the Collier Population of East Lothian, by S. Scott Alison, MD, Hon. Sec. Medical Society of London.

The physical condition of the collier population of East Lothian, in North Britain, including men, women, and children, is bad, and much inferior to that of most other classes of the population which have come under my observation.

At birth, the infants of colliers, as might be expected, are not much inferior in physical condition to those of other classes, but before they have lived many weeks, or months, a inferiority is observable, especially to the children of farm-labourers, and of other individuals in comfortable and respectable circumstances.

Many of the infants in a collier community are thin, skinny, and wasted, and indicate by their contracted features and sickly dirty-white, or faint-yellowish aspect, their early participation in a deteriorated physical condition.

This inferiority of constitution is the result of many causes, varying in their nature but assimilating in the production of a common effect. Among the causes of this deterioration of health may be enumerated, - unwholesome milk, the product of a mother the victim of disease or of intemperate habits; the irregular and insufficient supply of milk, in consequence of the absence of the mother, who is engaged in the colliery; the indiscriminate and premature use of coarse and irritating food, which frequently induces relaxation of the bowels, and the manifold ailments which collier people group under the title of "bowel hive;" the too long continued exclusive use of the mother's milk, which not infrequently forms the chief sustenance infant for the first eighteen months or two years of its existence - a course too frequently pursued in order to save the pockets and the exertions of the parents; a filthy condition of the person; the presence of the alvine and urinary discharges upon the skin and clothes, which not only irritate the integuments and interfere with its functions, but which very frequently produce such an impure atmosphere around the little victim as must be very unfavourable to its health and vigour.

Many of the infants in a collier community are the subjects of morbid habit of body, which they have derived from their parents, and of deformity; but I am not prepared to say that deformity at birth is more common among the offspring of colliers than among that of other classes of the community.

From the age of infancy up to the seventh or eighth year, much sickliness and general imperfections of physical development is observable, and this is owing to the comparative inattention of the mother to the maintenance of cleanliness of her children's persons, to irregularity as to time in their meals; to the use of improper articles of food; to insufficiency of culinary process; to excessive quantity of food at one time, and to too little at another; to the practice of giving whisky either raw or diluted with warm water; to insufficiency of clothes, which are in many cases both filthy and ragged, and almost always quite inadequate to protect against the inclemency of the weather; to the inhalation when within doors of an atmosphere rendered noxious by damp, by human respiration, and by the various impurities which are almost constantly found in the abodes of this class of persons, proceeding from the inmates, which not infrequently include horses, pigs, fowls, dogs, and cats.

The physical condition of children belonging to colliers is much deteriorated by the practice, which is very much in use, of tender children being put under the care of young girls of perhaps from eight or ten years, while the parents are engaged in the colliery, which is often for 10 or 12 hours at a time.

At the age of seven or eight years the children of most colliers, who are in tolerable health, begin to work in the collieries, either with their parents, which is the most common course, or with strangers, who hire them, which is the common practice with those who are orphans.

The children thus early employed, who come under my observation, were supposed to perform work of a fatiguing or laborious character, were employed for many hours together, perhaps from 8 to 10 or 12, without coming to the surface, were in the habit of working not only during the day, but during the night also. I have seldom walked or ridden through the coal villages at any hour during the night, summer and winter, without seeing little boys and girls going to and from the collieries, with their oil lamps in their hands or stuck in their caps, lighting them on their weary way.

The children generally take some food with them to the colliery, such as bread and cheese, but I am not aware that the food is taken is more than is necessary to banish hunger. On their return home the children take food, which is generally substantial and well prepared, when the mother or older sister happens to be a good manager. After eating, the children sometimes wash, but I have very often found them lying sound asleep upon the hearth, completely overcome with their severe exertions, and still covered with their working clothes.

The physical condition of the boys and girls engaged in the collieries is much inferior to that of children of the same years engaged in farming operations, in most trades, or who remain at home unemployed.

The children are, upon the whole, prejudicially affected to a material extent in their growth and development; many of them are short for their years; a considerable number fall into disease, both of an acute and of a chronic character, and several become crooked, and the subjects of spinal curvature.

The muscular system almost monopolises the comparatively feeble energies of the young frame and exhausts those stamina which should go, and are intended by nature to be expended in the development of the intellect and of the moral feelings, and of the manifold and various faculties of the human body. The nervous system, including the various parts of the brain, are comparatively little exercised, while that of the muscles is inordinately overworked; and thus the collier becomes more a mining or working animal than a thinking being - more a machine than a rational creature.

Ere these children have been many years in the collieries death has thinned their ranks; many lose their lives, both immediately and remotely, in consequence of violence; some are killed instantly by machinery or waggons, by the rending of ropes, by the falling of stairs, rocks and coal. Some, after surviving weeks, or months, or perhaps years, die at last of their injuries; while others escaping with life remain, during its whole course, maimed or crippled, or perhaps totally disabled for exertion. Wounds are very commonly suffered by these children as may readily be supposed from the numerous scars and seams which their frames present. Where these wounds occur in the limbs, are deep, and penetrate the sinews, much impediment to labour is induced. I have attended young boys and girls on innumerable occasions for contusions and lacerations of their limbs. Fingers and toes have been severed by violence, or so severely lacerated and injured as to require immediate amputation. The eye-sight is frequently injured at this age, by the accidental intrusion of coal-dust or other materials; inflammation is induced, and the loss of one eye has been a not unfrequent result. Cough and difficulty of breathing is not uncommon among the boys and girls; and hypertrophy, or enlargement of the heart, has been frequently observed by me among the former, ere they arrive at manhood.

About the age of 20 few colliers are in perfect health, almost all being more or less affected with difficulty of breathing, cough, and expectoration, either occurring occasionally or in a permanent form. The body of the adult collier at this age is generally spare, the muscles and sinews being well developed, and well marked in their outlines; there is little superimposed fat, and the strength of the muscular system is altogether very considerable. When not suffering from disease, the collier generally eats well, and in short, with the exception of respiratory organs, all his parts perform their functions aright.

The women at this age are in general healthy, muscular, and not deficient in fat. The strength of these women is great, and I am not aware that their employment in the collieries is generally productive of deformity of such a nature as to render parturition difficult. Several of them are distorted in the spine and pelvis, and suffer considerable difficulty in consequence at the period of parturition; but I am inclined to think, where this has not arisen from direct violence, that it has been induced by general debility and bad habit of body, induced in infancy or childhood. Many women at this age are found to suffer from the effects of violence. The violence has generally proceeded from contusions from collision with waggons, from the fall of stones and coals; and the effects of this violence are lameness, imperfection in motions of the limbs, hands, and feet, abortion and premature parturition.

Between the twentieth and the thirtieth year many colliers decline in bodily vigour and become more and more spare; the difficulty of breathing progresses, and they find themselves very desirous of some remission of their labour. This period is fruitful in acute diseases, such as fever, inflammation of lungs and pleura, rheumatic fever, and many other ailments, the product of over-exertion, exposure to cold and wet, violence, insufficient clothing, intemperance and foul air.

After the thirtieth year it is rare to find a perfectly healthy collier; and so much so is this the case, that perhaps not 1 in 50 could pass the necessary examination to enter as a soldier into Her Majesty’s service; the difficulty of breathing becomes aggravated, the shoulders are drawn up, the respiratory muscles of the neck and breast become very prominent, and the cough seldom ceases for more than an hour or two day or night. The muscular strength generally declines fast, and so very weak are some before they reach the fortieth year, that they are unable to work more than two or three days in the week, and even when their symptoms do not indicate any other disorder than that of the breathing apparatus.

The period included between the fortieth and the fiftieth year is marked by a rapid decline in the health of the collier; the symptoms of decay now succeed fast, and death is busy in the selection of his victims.

After the fiftieth year comparatively few survive, and those who, by dint of greater strength of constitution, of temperate habits, and attention to the preservation of health, are still left, for the most part are broken down and decrepit.

Few are seen above 60 years of age, and a collier at 70 has seldom come under my notice.

The physical condition of women suffers less than that of the men, and the health of the former declines less rapidly than that of the latter. Many women engaged, or who have engaged in coal work are seen at middle age, in the enjoyment of good health; and I have frequently met with collier women at 60 or 70 years of age nursing their grand-children, and promising well to survive a few more years. This greater amount of health, vigour, longevity among the females is owing to their less constant presence in the colliery, to their not being employed in the hewing out of the coal, or in the cutting of the stone dykes, and also to their early retirement from the under-ground labour, which very generally takes place as soon as the children are far enough advanced to assist the father, or (if he is dead, as is commonly the case) the older brother.

The most common diseases of infancy are not different from those which affect the children of other classes in this country. Some, though not peculiar to collier infants, yet are more commonly remarked among them than among the infants of those classes of the community who are in more comfortable circumstances, and who take better care of their offspring, and others, although not more commonly remarked in this class of infants, are yet much more who are in more severe and much more mortal.

Amongst the first may be ranked inflammation of the bowels, and of their internal covering the mucous membrane, diarrhoea, prolapsus of the rectum or lower bowel, worms, vomiting, atrophy or wasting from strumous enlargement and degeneration of mesenteric glands, inflammation of the lungs and their covering the pleurae, inflammation of the windpipe where situated in the neck, consisting of laryngitis and croup and in its lower part, when distributed to the lungs; constituting bronchitis, a very common disease among those children who are neglected and exposed to cold ; inflammation of the brain and of its coverings, both acute and chronic, ending in the formation of water, purulent matter, softening and degenerating of the structures; irritation of the brain attended by convulsions and not unfrequently terminating in loss of voluntary motion in a part, or one or more, of the external or internal senses; itch, the various rashes, the various forms of porrigo; excoriations about the private parts from the continued presence of excretions; burns, scalds, contusions from falls and violence, scrofula in various forms and general debility and emaciation of body; small-pox, proceeding from contactual contagion and the venereal disease, contracted before or at birth.

The diseases which, though not more commonly remarked amongst collier infants than others but which are generally more severe are the specific diseases of children, viz., measles, scarlet fever and hooping cough. These diseases are not more severe but are also very much more mortal among the children of colliers than among those of farm-labourers or hinds, farmers or persons in comfortable circumstances. The mortality of measles and hooping cough is much increased by the common supervention of inflammatory action in the bronchial tubes and in the lungs. The mortality of scarlet fever is also increased by the accession of over action of brain and its coverings of the lining membrane of the bronchial passages and of the air cells of the lungs during the active stage of the disease and convalescents not unfrequently die of general dropsy, the product of disease of the kidney, which has been induced by exposure to cold, soon after recovery from this very important exanthema. Many convalescents from scarlet fever have died under my care in consequence of the supervention of dropsy.

Inflammation of the bowels among collier infants has frequently come under my care and many deaths have occurred therefrom. It attacks at any period from the first few hours of life and is more mortal the younger the infant is; and runs its course in a few hours marked with much agony. The causes are exposure to cold and the introduction into the stomach of acrid agents, such as whiskey- toddy and coarse food. Then the disease is confined to the mucus membrane there exists less danger and the little patient is troubled with frequent dejections of slimy and bloody stools.

Diarrhoea is a very common disease of collier infants and although by no means a mortal disease yet carries off many children, both immediately and remotely, by the supervention of other maladies. Many infants suffer great relaxation of the bowels for weeks and months together, and have no attention paid to their ailments but are treated in the usual indifferent manner. The persons and clothes of many are seldom washed and the little sufferers seek relief when and where the call is made; and in consequence of this their persons and apartments pollute the surrounding atmosphere to such a degree as to render it highly disgusting. I have known the bowel to be forcibly extended to a considerable extent in consequence of the irritation of long-continued looseness and I believe the injury would be of a permanent nature. This disease weakens the whole system, drains the fluids, interferes with the digestive processes and induces ulcerations of the bowels, enlargements of the mesenteric glands, and that general atrophy which again leads to the formation of many serious diseases and more particularly those which are characterised by the strumous character.

The causes are, unhealthy milk from the mother, coarse and irritating articles of food, raw and unwholesome vegetables or fruits, inattention to provide that diet which is suitable for delicate children and the abuse of strong purgative medicines; insufficient clothing, suppression of the transpiration of the skin from cold, or the constant presence of filth upon that important organ.

Worms are very common among collier children, particularly the lumbrici and the asarides. The presence of these, as well as all parasites, for the most part depends upon a want of vigour either in the whole system or in that part only in which the parasites reside. These worms where there exists general debility go to increase it and where the general health is good frequently break it down, by interfering with the digestive processes, by inducing looseness of the bowels, by propagating irritation to the spinal marrow and brain, thereby inducing convulsions, palsies, and hydrocephalus and by preventing the growth and development of the various organs of the body.

Tabes mesenterica, or mesenteric consumption of children is a common affection among collier children and is far more frequently found amongst them than among the children of persons in comfortable circumstances. I think it may be in some measure dependant upon a general strumous habit of body but I have generally found it existing under circumstances which have lead me to regard it as chiefly the result of neglected diarrhoea, intestinal irritation and errors in diet. The affected glands become enlarged and often reach the size of field beans or even of a hazelnut; and when divided they present a yellowish cheesy aspect and are often of a soft consistence. Death is a common result of this disease but many children have assuredly undergone great disease in these parts upon being put upon a course of life of a more salubrious character, have been restored to perfect health. This disease is readily distinguished by the great emaciation of the body, not necessarily accompanied by errors in respiration, by hardness and enlargement of the belly, and generally by frequent dejections of a mucous or white colour.

Inflammation of the windpipe at its course in the neck and in its ramifications in the lungs, of the lungs and of their coverings, are very frequently remarked among collier children, but not more frequently than among the offspring of other classes in the same moral and domestic condition.

Laryngitis and croup hurry off their victims within a few hours; and in general so rapid is the progress of these diseases, and so severe their character, that the infant is very frequently moribund when the medical attendant pays his first visit. I have attended many infants under croup, and have reason to think that many have been saved by the immediate adoption of the most powerful remedial agents, who would doubtless have expired had these measures been delayed one hour longer. Many have died who might have been saved under tolerable activity on the part of parents in procuring medical assistance; and the melancholy fact is well known to me that some children who had been extricated from the jaws of death by dint of great exertion, have forfeited their lives to the after carelessness and supineness of their parent who, instead of cherishing and protecting them, have allowed them to wander to the door and to be exposed to the inclemency of the weather.

Inflammation of the windpipes at their distribution in the lungs is a very common disease among collier infants and I am pretty certain that few arrive at the eighth year without having experienced at least one attack. When the infant is very young death is a very common termination of the disease and when the child is fortunate enough to recover from this complaint he very commonly suffers for months and even years, an occasional difficulty of breathing, cough and wheezing, which are very liable to be aggravated upon the slightest exposure to damp or cold.

Inflammation of the lungs and their covering, the pleurae, is also frequently observed in collier children and is well known to be a very mortal disease. When it proves mortal in its acute stage death usually takes place within eight days, but where the patient survives this dangerous period he frequently suffers from serious morbid alteration of structure, such as condensation, obliteration of air cells, infiltration of purulent matter, the formation of abscess, the effusion of serum, or seropurulent fluid into the cavity of the pleurae and abnormal adhesions of the serous covering of the lungs, with the serous covering of the ribs. These morbid alterations give rise to difficulty of breathing and various errors in respiration corresponding with the character of the lesion which has been produced. The general health suffers, and the patient may die within a few weeks or may survive for years according to the progress and urgency of his symptoms.

These inflammatory affections generally proceed from cold, with which the patient has ample opportunities of meeting from exposed bosoms, uncovered feet, windows without glass, ill-fitting doors, houses anything but weather-tight and neglected respiratory ailments.

Inflammatory affections of the brain and its coverings come next to the preceding diseases in respect to frequency. Collier infants are very subject to these complaints, and many died annually in the district in which I resided, both immediately, and also at some distance of time, in consequence of various lesions induced in the structures which had been the seat of the inflammatory action. It is much more common for infants who suffer inflammation of these parts to die within a few days than to survive any considerable length of time; and those who survive the acute stage, for the most part die, of hydrocephalus, convulsions, and general atrophy, or suffer for the remainder of life imperfection of some or all of the intellectual or moral faculties, of the external senses and voluntary motion, in consequence of structural alteration. Some few recover their health entirely, and this occurs more frequently among the older and the more vigorous patients than among the younger. Many cases of general atrophy among collier infants have come under my care, and their history afforded good reason to make me believe that the weakness of the circulation, the imperfect nutrition, the imperfection or almost deprivation of voluntary motion, and the inertness of the moral faculties, depended entirely upon inaction of the nervous centre, which had been induced by inflammatory action, and which in all probability was co-existent with a preternaturally soft or otherwise unhealthy condition of the structure of the brain and spinal marrow.

The causes of these affections are numerous, and include blows, falls, dentition acting upon a patient of preternaturally excitable brain, worms, morbid and acrid secretions in the stomach, bowels, liver, and gall-bladder; the use of whisky, or other spirituous liquors; poisonous articles, including narcotics, &c.; and irritable condition of the mucous membrane of bowels, often connected with neglected diarrhoea.

Scrofula is very commonly remarked among collier children, and manifests itself at all periods from the first few days after birth. It assumes various forms, but the most frequent are, in early infancy, small circumscribed purulent tumours, about the size of field-beans, occurring on all parts of the body, commonly increasing slowly in size, and little disposed to ulcerate and evacuate their contents. This form almost invariably proves fatal in a few weeks. I remember attending one poor infant, and I believe I incised not less than 20 such purulent tumours. As soon as one set was disposed to heal another came out, and the patient ultimately died. Scrofula not unfrequently manifests itself in the form of severe and lasting irritation, frequently accompanied by ulceration at the various orifices of the body, where the mucous membrane unites with the common integuments, such as the edges of the eyelids, the nostrils, the arms, and the vagina in females.

Subcutaneous suppuration is also a common form of the disease. The skin is observed to be slightly elevated, and it feels baggy, affording to the fingers the sensation of fluctuation. If the humour, which is generally thin, greenish, and unhealthy-looking pus, be not evacuated it acts as a foreign body, separating the integuments from the subjacent adipose tissue in the direction of its gravity, and this is effected without any very obvious elevation of the separated integument. The most common seats of this form of scrofulous action are the integuments of the forehead, head, face, and neck. I have seen the eyelid the seat of this affection, and in one case loss of vision in the corresponding eye was the consequence, owing to the eyelid being so contracted by the cicatrix as to be no longer capable of covering the eye.

Enlargement, and a soft cheesy condition of the glands situated in the mesentery, is another form of infantile scrofula, and frequently occurred among the collier infants who came under my care. This scrofulous condition of these glands gives rise to emaciation, hectic fever, fulness and hardness of the belly, which together constitute the disease which has been already noticed as tabes mesenterica, or mesenteric consumption.

Scrofula is frequently developed in the lymphatic glands of the neck, axilla, and groin and is characterised by slow suppurative action. The purulent matter is generally thin, sometimes greenish, and mixed with white curdy flakes, but is also sometimes of a brownish colour, like toast-and-water, and very thin in consistence. The fluid sometimes forms a circumscribed tumour, but very frequently burrows under the integuments, vessels and muscles to a very considerable extent, unless the bistoury is effectually applied, and even in spite of this the burrowing occasionally goes on. The muscles, veins, and arteries are frequently as completely separated as if they had been dissected by the anatomist. A poor emaciated girl, suffering with a scrofulous abscess of this nature, at the angle of the jaw, had her last frail link with life wrenched asunder by a copious bleeding which took place from a vessel which had become ulcerated. After death I examined the abscess, and found the cavity filled with clotted blood, and the parts as nicely dissected as I had ever seen them in the dissecting room.

The spongy parts of the osseous system, including the heads and articulating surfaces of the long bones, the short bones, the bodies and processes of the vertebrae, and the ethmoital bone, are the common seats of scrofulous action in collier children, giving rise to white-swellings when the joints are implicated, to the formation of purulent matter, abscess, and cloacae. When the vertebrae are the seat of the disease, which is very commonly the case, the spinous processes swell, project, and are painful to the touch. When in this condition they are said to be carious, and may become the seat of suppuration giving rise to lumbar abscess. The anterior part of the vertebrae, viz. the body, is likewise subject to this scrofulous caries, perhaps more so than the spinous processes; and when suppuration takes place, and the purulent matter, after coursing along the psoae muscles, is evacuated at the groin, the disease is called psoas abscess. I have met with many collier children labouring under lumbar and psoas abscess. The fluid was usually poured out in great abundance, bearing out occasionally a particle of bone, was thin and mixed with white curdy flakes, the flesh wasted fast, the healthy rapidly sank and death invariably terminated the protracted sufferings of the patients.

The causes of the various forms of scrofula to which collier children are subject, are hereditary disposition, in many cases dependent, in a great measure, on the practice of marrying relatives, which is very common among colliers, as is at once suggested by the frequency of the same name in a collier community; the irregular and unequal diet; dissipated habits; the inhalation of a polluted atmosphere at home; and, in short, the many sources of deterioration of health which are at once discovered by an inspection of the domestic condition of colliers.

The venereal disease, I have reason to think, is occasionally present in collier infants, having met with several children who had extensive disease partium generationis, which I doubt not was contracted before or at birth.

Fever is comparatively little observed among collier children for the first few years of life, although many cases of continued fever in infants under three years of age have come under my care. I have frequently found all the members of a family, including five or six children and the parents, ill of typhus fever at one and the same time, the infant, or youngest, only being free of an attack of this distemper, or only suffering under symptoms which could not strictly be called fever. Dr. Clutterbuck of London considers that acute hydrocephalus is to infants what fever is to adults, and although I cannot admit this proposition altogether, still I think that cerebral excitement tending to the formation of water may occasionally supervene during the fever of infants, and effectually disguise or supersede the original disease.

Fever proved mortal to collier children occasionally, but less frequently than to adults, in proportion to the numbers affected.

Accidents are very commonly experienced by collier infants as falls, scalds, and burns. Falls occasionally produced serious disease of the joints and spine. Scalds and burns occasionally proved mortal, and when the patient recovered serious contractions of the neck and limbs were the occasional results.

Boys and girls at the time of their commencing labour under ground are not, as far as I am aware, remarkable for bad health, but they now become exposed to many sources of disease and their frames are now the subject of much more tear and wear than falls to the lot of other children in the neighbourhood, who remain at school, or are employed at agricultural operations, or in the various trades.

It is unnecessary at present to enter into the particulars of each disease, and of the various injuries to which youths are subject, as these will be given when the diseases of the colliers come under observation; but I may here mention that these young people suffer much from inflammatory affections of the chest, from irritation in the bronchial passages, arising from exposure to cold, and from the inhalation of an impure atmosphere; that their growth in vigour and health and due proportion is very much deteriorated by excessive labour, irregular hours and by night employment; and that many of them become maimed, or are deprived of life by the various injuries to which they are subject in their employment, viz., contusions, fractures, wounds, and lacerations.

The diseases of the pectoral organs are so very common among colliers that scarcely an individual above the age of 20 years, who has been employed for a considerable time at coal work in whom these organs will be found in a healthy condition. Chronic bronchitis, or inflammation of the air-tubes of the lungs, is one of the most common diseases of colliers, and generally found superadded to every other disease, either of the lungs or of other parts, from which the collier may chance to suffer.

For the first few years chronic bronchitis is usually found alone and unaccompanied by disease of the body of the lungs. The patient suffers more or less difficulty of breathing, which is much affected by changes of the weather and by variations in the weight of the atmosphere; he coughs frequently, and the expectoration is composed, for the most part, of white frothy and yellowish mucous fluid, occasionally containing blackish particles of carbon, the result of the combustion of the lamp, and also of minute coal-dust. At first, and indeed for several years, the patient, for the most part, does not suffer much in his general health, eating heartily, and retaining his muscular strength little impaired in consequence. The disease is rarely, if ever, entirely cured; and if the collier be not carried off by some other lesion in the mean time, this disease ultimately deprives him of life by a slow and lingering process. The difficulty of breathing increases and becomes more or less permanent, the expectoration becomes very abundant, effusion of water takes place in the chest, the feet swell, and the urine is secreted in small quantity, the general health gradually breaks up, and the patient, after reaching premature old age, slips into the grave at a comparatively early period with perfect willingness on his part, and with no surprise on that of his family and friends.

So seldom is this disease entirely cured, that many individuals who have in youth worked a few years only at coal-work, and have then left it for some other employment, have continued during the remainder of life subject to cough, and to expectoration, which has occasionally been black. I have met with many individuals who have returned to East Lothian after an absence of many years, during which they had been employed in different capacities, as soldiers and trades people, who have continued to cough and to expectorate blackish or bluish mucous.

Spurious melanosis, or "the black spit" of colliers, is a disease of pretty frequent occurrence among the older colliers, and among those men who have been employed in cutting and blasting stone dykes in the collieries. The symptoms are emaciation of the whole body, constant shortness and quickness of breath, occasional stitches in the sides, quick pulse, usually upwards of one hundred in the minute, hacking cough day and night, attended by a copious expectoration for the most part perfectly black, and very much the same as thick blacking in colour and consistence, but occasionally yellowish and mucous, or white and frothy; respiration is cavernous in some parts and dull in others; a wheezing noise is heard in the bronchial passages, from the presence of an inordinate quantity of fluid; the muscles of respiration become very prominent, the neck is shortened, the chest being drawn up, the nostrils are dilated and the countenance is of an anxious aspect. The strength gradually wasting, the collier who has hitherto continued at his employment finds that he is unable to work six days in the week and goes under ground perhaps only two or three days in that time; in the course of time he finds an occasional half days employment as much as he can manage, and when only a few weeks or months journey from the grave ultimately takes a final leave of his labour.

This disease is never cured, and if the unhappy victim of an unwholesome occupation is not hurried off by some more acute disease, or by violence, it invariably ends in the death of the sufferer. Several colliers have died of this disease under my care, but the number is inconsiderable compared with those who have fallen under the less alarming and less rapid strides of bronchitis, with its numerous complications. William Swan, aged 44 years, died of this disease under my charge in 1835. According to a note of the case which I preserved, I find that he expectorated fluid having much the appearance of thick (black) ink, and having not the least particle of white mucous or of pus apparent; pulse 120, body much emaciated, and urine high-coloured and scanty. This man had been engaged from boyhood as a collier and had for 18 years been occasionally employed in blasting stone dykes with gunpowder. At the time of my attendance on this poor man I was told that he was the last surviving man of a "company" of several men, amounting, if I recollect aright, to 10 or 12, who had been employed only a few years back in blasting stone dykes in a colliery, all or most of them having died of the black spit, or spurious melanosis, at an early age, the identical disease of which poor Swan was dying.

When the lungs of persons who have died of this disease are examined after death, they are found to be of a black colour, as if dyed, and to be the seat of much morbid alteration. Cavities or caverns are discovered in these organs, chiefly at the superior parts, containing more or less black fluid of some consistence, and communicating for the most part together. When lungs thus blackened and diseased are pressed, black-coloured serum or fluid is obtained, from which, and likewise from the fluid contained in the caverns, an extract may be obtained which burns with a flame the same as coal, and which when subjected to heat evolves gas similar to coal-gas, and which is combustible. The parts of the lungs adjacent to the caverns are generally condensed and edematous.

The causes of this singular disease are coal-dust, the carbon evolved by the combustion lamps, and by the firing of gunpowder, and also the stone-dust disengaged during the disintegration of "the dykes" in collieries. The blackened colour of the lungs, and the fluids contained within them, obviously depend on the presence of minute coal-dust, and the disengaged carbon of the lamps, and of the gunpowder used in blasting. It appears to me that the changes brought about by these black bodies are chiefly the dying of the lungs where there already exist caverns, and where these caverns do not exist a certain amount of irritation in the bronchial passages and air-cells of the lungs, for the most part giving rise to violent bronchitis only, attended by thickening of the mucous membrane, and a copious secretion of mucous or muco-purulent fluid, to which they impart the black dye. But I am inclined think that though these black agents seldom induce the black spit, haracterised by degeneration of the lungs and by caverns, that they may sometimes bring about this disease where they are present in large quantity, and are continued for a considerable length of time and when moreover the pulmonary tissue on which they are operating proves to be more than usually delicate and prone to ulcerative action.

My reasons for holding this opinion are the following: First, persons out of number inhale minute coal-dust and the disengaged carbon of lamps and gunpowder for many years, and continue to spit during that time blackish expectoration without having any indication of more serious lesion than that of bronchitis, with its usual complications, and certainly without the usual symptoms of cavernous lung. Secondly, minute coal-dust, and disengaged carbon the product of combustion, are neither of an acrid nature, nor of that mechanical irregularity which would necessarily irritate the pulmonary tissue to such an extent as to produce inflammatory action, and caverns in an organ defended by a nervous coat, lubricated by fluid and possessed of means to throw off foreign agents. That coal-dust is neither acrid in its chemical nature nor irritating in its physical character is sufficiently proved by the fact, of the truth of which any one may satisfy himself, that coal-dust remains for years under the integuments of colliers without producing the slightest inconvenience, excepting the disfigurement attendant upon the presence of black spots. Many colliers may be seen with black discoloration of the white membrane of the eye, from the presence of coal-dust, without suffering the slightest pain, morbid action, or inconvenience of any kind in consequence.

The chief cause of the degeneration and of the caverns of the lungs in colliers suffering under black spit appears to me to be the stone dust disengaged during the disintegration of the dykes. Stone-dust is much more calculated than coal-dust to produce irritation, inflammation, and ulcerative action, from its greater irregularity and hardness. Sand rubbed in upon the skin produces irritation, and when introduced under the eyelids induces severe inflammatory action. Stone-masons suffer much from ulcerative action in the lungs, and from the formation of caverns in these organs, in consequence of inhaling the stone-dust which is diffused through the atmosphere by their chiselling operations.

I have frequently been informed by intelligent colliers likewise that the black-spit is rarely if ever produced in mere coal- hewers, and that it is chiefly or entirely confined to those individuals who have been engaged in stone-work.

The gaseous fluids evolved during the firing of gunpowder may likewise act an important part in the production of the morbid alteration of the lungs, which are remarked in those who die of blackspit. If this view of the case be taken it will appear that the spurious melanosis of colliers is simply the same disease to which stone-masons, needle-pointers, and others who inhale sharp, gritty, and irritating particles are subject, to which an additional feature, namely, the black colour of the lungs and expectoration, has been superadded, and which has been derived from the black colour of the coal-dust and disengaged carbon, the product of combustion.

Inflammatory affections of the lungs, their coverings the pleurae, and of the muscles of the chest, are very common complaints among colliers, and sometimes prove mortal. The chief causes are, sudden changes from heat to cold, suppressed perspiration, wet clothes, and exposure in going to and from the colliery.

I found the diseases of the heart very common among colliers at all ages from boyhood up to old age. The most common of them were, inflammation of that organ, and of its covering the pericardium, simple enlargement or hypertrophy, contraction of the auriculo ventricular communications and of the commencement of the aorta. The symptoms were well marked, attended for the most part with increase of the heart’s action, the force of its contractions being sensibly augmented, and in many cases, especially those of hypertrophy, much and preternaturally extended over the chest. The breathing was usually much affected, the pulse unnatural, sometimes irregular, intermittent, small, forcible, and jerking; at other times slow, large and feeble, according to the nature of the affection. A considerable number of those effected with the acute inflammatory affections recovered perfectly, but many only recovered partially and for the remainder of life suffered much annoyance and bad health from the consequences of these affections. Some suffered simple enlargement and experienced strong palpitations and difficulty of breathing. When the orifices became contracted, as frequently happened, dropsical symptoms intervened and carried off the patient.

The causes of the affections of the heart among colliers I regard to be the application of cold and wet to the body during and after work, violent straining and protracted exertions requiring deep inspirations, interruption to the flow of the blood from the heart, in consequence of extensive disease of the lungs and bronchial tubes and cells, and also of great deformity; and the excessive dissipation in which colliers too frequently indulge. These causes operated occasionally singly, but for the most they acted conjointly in the production of the diseases of heart.

Aneurisms and ossific deposits of the great arteries within the chest I found to be common among colliers and even among the women. I attribute these morbid alterations to the violent efforts which colliers are constantly in the habit of making, and to intoxication and tippling, which are well known to be productive of deranged nutrition of the heart and great vessels.

When aneurisms proved mortal death usually took place instantaneously.

Inflammatory affections of the stomach and liver are also common diseases among colliers, and in consequence of the induction of morbid alterations of structure, lead to destruction of health, and finally to premature death through the various steps of dyspepsia, intractable vomiting (occasionally of blood), diarrhoea (sometimes bloody), jaundice, and dropsy of the and belly. The chief cause of these affections, both in their acute and chronic forms, is excessive use of whiskey.

Hernia, or rupture, does not appear to have been more common among colliers than among labouring people.

The kidney is very frequently the seat of disease among colliers; inflammation of that organ comes occasionally under my care. Morbid alterations of urine were particularly common and gravel was frequently deposited. Several colliers died under my care with partial suppression of the secretion of that organ, and their cases were characterised by general dropsy, their urine becoming thick, and presenting white flakes like the boiled white of an egg upon the application of a boiling heat and by a lethargic condition of the brain, indicated by torpor of the mind in all its divisions. The causes of the more serious diseases of the kidney were, exposure to cold while the body was perspiring freely, working for hours together amid water with wet clothes, contusions on back and loins, and excess in whiskey.

The two first-mentioned causes were found to be in operation in the greatest number of the cases of organic alteration; contusions and falls were the occasional exciting causes, and were generally attended by bloody urine, while a large majority of the merely functional derangements was referable to dissipation.

Diseases of the spinal column are very common at all ages among individuals employed in collieries. I have attended many persons labouring under the most serious of the diseases which are incident to the spine. Few middle-aged or old colliers are to be seen without curvature of the spine more or less extensive, the result of the unnatural position in which their bodies are retained for hours together when at work. This affection is indicated by general crookedness of the trunk, by stooping, and in general by one shoulder being higher than the other. The health of the collier does not necessarily suffer from mere curvature of the spine, although it is frequently found that curvature is most complete in those of delicate health.

Caries of the vertebrae of the back and loins very frequently come under my charge in the persons of young and middle-aged colliers, and has almost invariably terminated in the formation of lumbar and psoas abscess. Of the many colliers who suffered under these abscesses not one individual recovered. The size to which the external tumour sometimes attained was enormous, and the quantity of fluid which was wont to pour out daily, for weeks in succession, was very great. I have known some of these colliers to go about and work after the tumour had obtained considerable size, in order to maintain themselves.

The causes of caries of the spine, and of lumbar and psoas abscess, are, for the most part strumous habit of body, great external violence, inducing inflammatory and subsequent suppurative action, and moderate violence or exertion concurring with a strumous disposition.

The diseases of the nervous system are, on the whole or taken collectively, not very common among colliers, certainly much less frequent than among the pampered and luxurious; but some individual forms of nervous disease are frequently observed.

Palsy of the lower extremities, both complete and partial, are more common, among colliers than among persons engaged in agricultural operations, or in the various handicrafts. I have known many colliers at an early age to be martyrs to this affection, in its various shades, from debility and a tottering condition of the limbs to downright insensibility and complete loss of voluntary motion. Some colliers who suffered the milder forms of this disease merely were enabled to continue at work, while of those who were affected to a more serious extent the greater part remained helpless; a few recovered so far as to permit of their working a little in the collieries, or to follow some more easy occupation, such as driving a horse and cart, a very common resource among the crippled, and a considerable number died in consequence of coexistent injury to other parts. The most common, nay the almost invariable cause of this disease among colliers, was the application of violence to the spine, received in their occupation as colliers. A few cases of partial loss of power and sensibility arose from blows and injuries inflicted on the head. In 1837 a poor lad, about 20 years of age, named Rutherford was affected with this disease: he received a most severe injury on the back and upon the lower extremities. His limbs were cold, senseless, and motionless; the bladder was paralysed. After suffering dreadful agony for several days he died. On examination after death lumbar portion of the spine was found to be dislocated, the body of one vertebra being driven considerable space before the one above it.

In 1836 a young collier, about 30 years old, named Duncan, suffered a somewhat similar injury of the spine, and was considered for some time in a dying condition; the bladder was paralysed, and likewise the lower limbs. In addition to this there were serious injuries other parts. This man recovered sufficiently to go about, and although unfit for laborious occupation, went below ground again, but finding it impossible to continue at that employment, sought a livelihood by hawking articles about the country with a pony and cart.

Convulsions take place occasionally among colliers, and are produced chiefly by the extensive use of whiskey.

General paralysis, or palsy of one side, occurs not unfrequently, but certainly much less seldom than among men of studious and literary habits. The chief cause is the long-continued practice of drinking whisky to excess. I do not remember having met a case of this or any other cerebral disease produced by mental exertion or by moral causes.

Hypochondriasis I never met with in a collier, and insanity has seldom come under my notice in a collier community, and those who were thus affected were, almost without exception, puerperal women, or young persons labouring under organic disease of the brain.

Common hysterical convulsion fits were not uncommon, but the singular and anomalous forms of hysteria, in its modern wide acceptation, were rarely remarked among collier females. I found whiskey to be the common exciting cause of these convulsion fits, and the subjects were generally strong and florid young women.

The various forms of continued fever were very prevalent among the colliers who came under my observation. It was a common thing for many families in the same village to be ill of fever at the same time, and for the members of all these families to be affected. I have seen many occasions the two beds in a collier house filled with persons labouring under typhus fever each containing four and five at the same time. So common is fever among the collier population, that comparatively few are to be found at the thirtieth year who have not suffered this disease. Death is a common termination of this disease at all periods of life. The old very frequently fell under this malady; the middle-aged died less often; and the young recovered in the greatest numbers.

Many heads of families died of this disease, under my care, and the privation and destitution consequent on this event was frequently of a very aggravated character. I do not think fever was much more prevalent among colliers than among other labourers.

The exciting causes of this disease are chiefly referable to the habits of the colliers, to the condition of their domiciles, and to that of the atmosphere around their dwellings. The habits which are productive of fever are dissipation, irregular dieting, and general recklessness. The conditions of the domiciles favourable to the invasion of fever are those of non-ventilation, darkness, accessibility to the wind and rain, general filth, the presence of impurities, and the general absence of necessary furniture and utensils. The condition of the atmosphere around the dwellings which favours the invasion of fever, proceeds from the presence of heaps of corrupting animal and vegetable materials, known as dunghills, and commonly present before the houses of the collier population.

Injuries from external violence were very common among the persons engaged in the collieries with which I was connected, constantly incapacitating persons for employment, leading to premature death and to permanent maiming. During the seven years of my residence in Tranent, injuries from external violence came under my care almost daily, and comprehended all shades of cases from the comparatively trivial to the most serious and dangerous accidents, ending in immediate death. So frequent were accidents of a serious nature that I was never a few miles from home without feeling impatient to return to my post, fearing that emergencies would be occurring.

I possess materials for the construction of tables of the various accidents which come under my care but the few days which have been allowed for the collecting of this evidence, scarcely suffice for the purpose. In 1838 five individuals died of injuries received in coal-works in Tranent, and came under my observation.

In order that some idea may be readily given of the mortality which occurred amongst the population under my care, and also of the nature of the diseases and injuries which proved fatal I will here give a table of the deaths which occurred, in 18__, under my care. The total number of deaths was 59.

1. A young girl, aged 14 years, the daughter of a collier, was burned to death.
2. A girl, aged 4 years, the daughter of a collier, died of croup.
3. A woman, aged 44 years, wife of a hind, died of typhus fever.
4. A child, aged 20 months (collier), died of convulsions.
5. A young man, aged 23, collier, died of dropsy.
6. A woman, aged 70, wife of a collier, died of disease of the stomach.
7. A man, aged 48, shoemaker, died of disease of the stomach.
8. A man, aged 65, wright, died of erysipelas of the head, from a wound.
9. A man, aged 58, hind, died of typhus fever.
10. A girl, aged 10 years, farmer, died of inflammation of the bowels.
11. A potter, aged 74, died of typhus fever.
12. A man, about 40 years of age, collier, died of vomiting of blood.
13. A man, aged 48, a collier, died of disease of the lungs, induced by occupation.
14. A man, aged 22, employed at a colliery, died of injuries received at work.
15. A woman, aged 24, died of injuries received in a colliery.
16. A girl, aged 4 years (collier), died of hooping-cough.
17. A girl, aged 20 years, died of typhus.
18. Mrs. _______, aged 70, died of palsy.
19. A girl, aged 4 years, died of water in the head.
20. A girl, aged 4 years, died of typhus fever.
21. Mrs. ______, died of disease of the heart.
22. Mrs. ______, died of pulmonary consumption.
23. A child, aged 2 years, died of disease of the brain.
24. A man, aged 24, collier, died of dropsy.
25. A child, about 3 years of age, died of fever.
26. A girl, aged 4 years, died of tabes mesenterica.
27. An infant, aged 2 weeks (collier), died by overlaying, through drunkenness.
28. An infant, aged 6 months (collier), died of neglected inflammation of the bowels.
29. An infant, aged 4 months, died of small-pox (not vaccinated).
30. A young man, aged 17, died of scrofulous sores.
31 An infant (collier) died of inflammation of the bowels.
32. A boy, aged 12 years, died immediately, of injuries received in a colliery.
33. An infant, aged 7 months, died of diarrhoea.
34. A man, aged about 44 years, suddenly dropped down dead at his employment, probably owning to the bursting of an aneurysm.
35. A man, aged 34, died of dropsy.
36. An infant, aged 1 year, died of suffocation, from overlaying, through drunkenness.
37. An infant, died (cause not mentioned).
38. Mr. Farmer, aged 90, died of natural decay,
39. Mr.______, aged 72, grocer, died of cancer of the lower jaw.
40. An infant died in process of delivery.
41. A woman, aged a bout 50, died of procedentia uteri.
42. A girl. aged 5 years, died of croup.
43. A boy, aged 12 years, died of inflammation of the brain.
44. A young man, aged 20 years, died in consequence of contusion of the knee-joint, received in a colliery.
45. A woman aged 50 years, wife of a hind, died of bronchitis.
46. An infant aged 6 months, died of inflammation of the bowels.
47. A man, aged 35 years, was killed in a colliery.
48. A boy, aged 11 years, collier, died of dropsy.
49. An infant, aged 3 months, collier, died of a very severe catarrh from cold (the wind blowing through the house).
50. A girl, aged 8 years (collier), died of small-pox (not vaccinated).
51. A boy, ______, pauper, died of small-pox (not vaccinated).
52. A girl, aged 4 years (collier), died of small-pox (not vaccinated - sister of 2nd last).
53. A woman, aged 35 years, died suddenly from rupture of wound during delivery (a midwife attending).
54. An infant, aged 5 months, died of acute disease of the brain.
55. A child, aged 8 years, died of typhus.
56. An infant, aged 18 months, died of hooping-cough and tuberculous lungs.
57. An infant, aged 4 weeks, collier, died of small-pox (not vaccinated).
58. An infant, aged 3 weeks (collier), died of inflammation of the bowels.
59. A man, aged about 30, hind, died of confluent small-pox (vaccinated).

The rate of mortality among collier people is very high, but I have not made any calculation on the subject. The parish records do not afford all the necessary information for the purpose, neither do my own tables, as the deaths of those only are recorded in the parish books who are buried in the parish, and as I did not attend all the collier people who died in my neighbourhood.

By a statistical inquiry, however, which I made into the duration of life among the colliers of Pencaitland Colliery, I found that the aggregate age of 35 male heads of families was not more than 1192 years, giving an average for each of 34 years only.

This result appears very remarkable when contrasted with a similar inquiry, which I made with the duration of life among the male heads of farmer families. The aggregate age of male heads of farmer families was found to be not less than 1715 years, giving an average for each individual of 51 years and 10 months.

The direct influence of the occupation of the collier in inducing disease, in maiming and disabling, and further in diminishing the duration of life, is very great, and I believe far beyond what is suspected by the public in general: nor is the indirect influence of the employment of these people, upon their health and lives, less startling; for I consider that the privation of education experienced by young people, the formation of irregular and dissipated and reckless habits by their early introduction into the collieries, and the insensibility to the comforts of life which marks those people, as fruitful in the highest degree in physical deterioration. The diseases, the general bad health, the maiming, the imperfect development, and the premature deaths which are daily observed among these people, are numerous beyond all ordinary belief and afford matter for the most serious, solemn, and melancholy contemplation. But when I regard the combined operation of the direct and the indirect influence of the occupation of the collier upon the goodly human fabric, in the deterioration of its physical condition, in the depravity and heinousness of its moral nature, in the induction of disease and suffering misery, and in the wholesale destruction of human life, I feel appalled with the contemplation, and question much whether the working of coal produces more happiness than misery.

Is such misery, suffering, depravity, and destruction of human life, necessarily connected with the working of this useful mineral? the philanthropist may well and urgently demand: or can it be a part of the great scheme of the Almighty that what should be a blessing has become a curse and that the coal districts, gifted with riches beyond conception, should become the habitation of the most worthless, the most imperfect, the most unhealthy, and the shortest-lived of the population? he may inquire who has the wisdom to trace every gift to the Author of all good.

No, can be the only reply; for human experience teaches that no such necessary connection subsists, and because God cannot make good the source of evil.

The means which have been adopted to secure the health of colliers, and generally to improve their condition, are the following:-

The prohibition of the sale of whiskey, in the immediate vicinity of the dwellings of colliers, has been adopted. Mr. Andrew Cuthbertson, the intelligent lessee of Pencaitland Colliery, I understand has for some years prevented the sale of whiskey in Newtown, the village inhabited by his colliers. The families belonging to this colliery are in a comparatively comfortable condition; are orderly, regular, sober, and on the whole religious and moral far beyond any other set of colliers with whom I came in contact. I do not think any such wholesome restriction has been in operation in any other colliery.

Schools for the education of children are to be found in almost all the collier villages and communities, and, to a certain extent, prove useful, but they offer no sufficient counterbalance to the evil operation of bad example afforded by grown-up men and women, with whom children come in contact in collieries, and for the privation of that training in domestic habits so essential to the formation of good housewives, but which is denied to collier girls by the practice of mothers working below ground.

Mr. F. Cadell, the manager of Tranent Colliery, laudably originated a school for the instruction of collier children. He, I believe, built the school-house, and defrayed part of the expenses of the establishment; but, for reasons with which I am imperfectly acquainted with scheme did not answer, and, after a few months duration, was finally discontinued.

Both clergymen in the village of Tranent are very earnest in the condemnation drunkenness, and in the enforcement of sobriety. The Secession clergyman has been instrumental by means of a temperance society, in reclaiming many drunkards. A missionary likewise who was employed about two years ago, did much good, not only in a religious form, but also in the recommendation of habits of temperance and cleanliness.

The employers of the colliers are, for the most part, at all times, ready to assist in times of suffering and distress, sometimes with money, sometimes with food, and, on all occasions, with good advice.

A soup kitchen has, during several winters, been opened for the benefit of the poor and the sick, and its advantages have been largely partaken of by the colliers. Mr. Richard Forbert, the lessee of Elphinston Colliery, has, I believe, the credit of originating this laudable form of charity in Tranent; and I consider it due to him to say that no accident ever occurred in his work without the utmost solicitude being evinced, on his part, in favour of the sufferer, and that material and valuable assistance was at all times readily granted.

Many colliers belong to benefit societies, from which, during sickness, they derive small weekly allowances.

The temperance society of Tranent enrols among its members many individuals engaged in the collieries and some of them are very zealous in the propagation of their principles.

For the purpose of showing how much, I believe the habits of the working people to be the cause of many of their diseases, I will even at the risk of contaminating an egotism, mention, that so impressed was I with the opinion that the dissipation, the filth, the laborious and unequal toil, the bad condition of their houses, and the polluted atmosphere, common more or less to colliers and others, formed the root of much of their physical sufferings, that I published a small address on these and other subjects to the working people; and as the circumstances will prove the interest which Mr. Cadell takes in any effort made to improve the condition of the colliers, I may add that he, on that occasion, addressed a letter to me, in which he said:-

"I have read your able address to the working classes with much interest and satisfaction. By publishing it you have conferred a valuable boon on the inhabitants of Tranent where dissipation exists to such an appalling extent. On Saturday last I collected a few of the Tenant collieries and impressed upon them the advantages themselves and families would derive from reading, thinking, and following out the friendly advice given in the address, and told then that to encourage every one of them to possess it I would pay the one half of the price on their paying the other. Most sincerely thanking you for the good you have done, and will do, by the trouble you have taken in this matter I remain, &c."

I am of opinion that many measures might be adopted with great advantage, for improving the condition of colliers and collier children but as the few days I have been allowed for collecting these facts are already expended it is out of my power to enter into details; but this is of less consequence, as the perusal of the foregoing evidence( incomplete as it is, cannot fail to show what steps are necessary. as I have already made some suggestions on the subject in my Report on the Sanitary Condition of the Working Classes in East Lothian, furnished to the Poor Commissioners, and already widely circulated by them; and as my work on the "Propagation of Contagious Poisons," published at Edinburgh, in 1839, contains observations at some length on the means of promoting the public health.

I may be allowed, in conclusion, to say that no field offers a better promise of a noble harvest to the philanthropist than the condition of colliers, and that these people, if they but receive their due share of English justice and liberality, cannot fail to find their lives more secure, their moral condition elevated, and their sufferings much mitigated.

London, 20th August, 1841.