Document ExmJobkYx7RqRg9X2jZgRm8Gb

/NC.P -,r Mr. H. Mo^TAcrE MraiuT, h.d., called and examined. r. .4076. '{Chairman.) Are you. a doctor in practice in fc^fr-London?--Yes. 1 am senior physician at Cliaring CiXif* 'Hospital. ` p';vyu.7_: 4077. Are you able to give the Committee some in &/'!,."-`iormation on' the subject of fibrosis of the lungs pro- fc^-tduoed by asbestos dust?--I have had experience of one case/ which I had under observation for fourteen v;Vr jmmths. 4083. What was the outcome of it?--He improve.!. He was ill for a month before he came to the hospital. yMurr.raHv. Mif , but after being there two months he went back to his ' ' ' ' work. That was in the spring of worked for some months, then became ill again^and was re admitted to the hospital in April, 1900, where lie died. 4084. Was your diagnosis verified by a post mortem examination?--Yes. ' -4078. Is your evidence limited to that case ?--1 am 4085. Were there any tuberculous symptoms--No ; "afraid so, because at the time it occurred, which is there wera enlarged glands in his neck, but they were 1=5; ^seven years ago, I looked for statistics, but could find $*3?"none, and since then 1 have not come across another S'case. ' not tuberculous. 4086. If, alter his firat attack he had not goiio back to his work, do yv>u Junk lie would have survived?-- *sflD79. Hare you heard from any quarter that the That I can hardly say, because his first aitack of so- .$3'.'-'disease is prevalent among those employed in the called bronchiiik was some years before I saw him. '.work?---One hears, generally speaking, that consider* The disease was so far advanced when I first saw him iW able troable is now taken to prevent the inhalation of that it was simply a matter of time. flj. ''-'the dust, so that the disease is not so likely to occur as . heretofore. Y, -t ; : . . f. " 4080/ Do you think it still may oocur?--If there is .$ -dust, oertainly. ............... . jr s --^081. Have you any doubt in your mind that asbestos !* I dustt does cause fibrosis?--I think there is no doubt L-*:vf *it did in this one case. . .. - \ Y- 4082. Can you tell the Committee the particulars *-J f `'that .case ?--The patient -was a man A3 years v Y 'of ago.'. He had been at work some 14 rears. Th ,`.7lhe .first ten Of which he was in wh8t was called '"w '--th- "carding room;'which he said was the most risky h.-. 3'part of the work. He volunteered the statement that -of the 10 people who were working in the room when he 4087. (Profr*\nr Altl/utt.) Will you describe what you found on examination of the lungs?--They were ex tremely tough ami fibrous, especially the lower parts. 4088. What r their colour?--In pans a greyish* black. 4089. Were there large and visible strands of fibretraversing the lung, or was it a finer fibrosis pene trating in ail direction* ?--In the lower part the changu was uniform, about the centre the grey areas -wereintormingted with reddish areas containing some air. In the upper part there was comparatively little change except increased toughness. 4090. Was there much pleuritic adhesion?--Yes. ;-.'went into it he was the only survivor. I have no - evidence except his word for that. He said they al! .'/ii '.'diet somewhere about 30 ywrra c-f age. After he had I been'there 10 years he was put into another room, where n t.there was much less dust- During the latter part of the 10 years he had had two attacks of what were it----iv rdiaguoeed as bronchitis, whicli incapacitated him for a few weeks. In 1899, afier he had been a: work some jyears he -was *eaHo-me,-and.^L_found he. hac^ 4060*. Did you go further into any minute examina tion by mirroMvpe or otherwise?--Yes. 3 have here some photographs which were taken under Dr. Legce's direction from specimens prepared for me by ~Dr. Hosanquet. * 4091. (Dr. Lnjrir.) Can you tell the Committee what 1 asbestos is?-- Jr consists chiefly of magnesium and silica with umir iron and lime. fTT? juarkddhpu'Inonary fibrosis, which was more like 4092. (Profrvnr AUlmtt.) Are*these spicules spicules - _ iottcrls-astcma haa_an,Tthing.else_I had Been. * __ of asbestos f--Yes. > rz.-L'. 12S " MINUTES OF EVIDENCE: - -- ~ .ra/r.'/y. m. 4003. "W as tlicre rnucli dilatation of the bronchial ~21 urrriy, tubes?--Not much. M.l> 4094. Might asbestos be found in the sputa?--Yes; c examined the sputa anti found definite d'*st, but ' could nut definitely distinguish it from other dust of similar character. '*4 JW r Jl {{ "V * 4 .,.1 - 4095. "Were there no chemical means of distinguish ing it?--No, because in ganister disease there might be as much silica in the lungs. Portions of the lungs were analysed afterwards, but the analysis did not give any further assistance. 4096. There would be then-r.a:!tK5h0y method at the service of a medical referee, would there, of deciding by the sputa whether a person was suffering from * asbestos fibrosis or not?--I doubt it; I never heard of any. Yes. When this man first came u> the hospital he only complained of shortness of breath. His poise was 63. and his respirations were 33. 4099. bo that it is in accordance with your cxnen- . ence that there is something characteristic about the ;s far greater incapacitation of the patitr.t than the com paratively few physical signs would account for?--"kes. . 4100. Docs your case illustrate this general rule?-- * Yes. 4101. (Dr. T.ro-jt.) Was the sputmn examined for the presence of tubercle bacilli or not?--Yes. None "ere found. ' 4lC2. Did the condition of the lungs on the mortetu examination suggest any tubercular cavities?-- No. - 4097. from your experience in that particular case, do you think by examination of the sputa you could distinguish another case if you came across one ?--No ; one could gftc* a probable diagnosis, but could not be definitely certain the disease was not due to some other form of siliceous dust. . 4098. We ha\v b*en tub! that there is somethin;; characteristic in the earlier stages of dust-phthisis in 4103. In your experience at Cliaring Cross Hospital have you come acroes cases arising from any other dusty occupations which showed symptoms similar to those?--. Not precisely the same; I saw two or throe cases tome years aeo arising from brass dust, in which there were much the same symptoms, but the disease ran an acute*- course. 4104. Spoakinc cenoraKy, fibroid phthisis. eucb il .LvliU,.!]-.K'spllflls, is i'. " - 0 > Vr'?"v b ;; 4 J^ju/AiyiW C Cf" O'' r~<- <;' Mr. H. MomrACiTE Mran.iT, ji.b., e&Ued and examinee. *. '-4076. '(CVioiVtnnn.) Are you. a doctor in practice in i////-London?--Yes. 1 am senior physician at Diaring v//// Cuis* `Hospital. 4077. Are you able to give the Committee some in- tA/cl'-formation on the subject of fibros-.s of the lunrs pro- ^^`.'-duoed by asbestos dust?--I have had experience of one V-case,- which I had under observation for fourteen immths. ` 4083. What was the outcome of it?--He- imnroveJ. He was ill for a month before lie came to the hospital Mr. H. if .Murray, v bui after being there two months he wen: ba-*k to in work. That was in the spring of worked for some months, then became ill agalr^ahd was re admitted to the hospital in April. 1600, where lie died. 4084. W*a your diagnosis verified by a pjst-mortem examination ?--Y.-s. .Lr-'V -4078. Is your evidence limited to that case?--3 am 'afraid so, because at the tune it occurred, which is ;zj; seven years ago, I looked for statistics, but could find &5Y"none, and since then 1 have not come across another fa v'case.,, .; L-&5' *'<079. Save you beard from any quarter that the 1$3 J- disease is prevalent among those- employed in thE *5 /work?--One hears, generally speaking, that consider /. able troablo is now taken to prevent the inhalation of v2-*'-'th* dust, so that the disease is not so likely to occur as . heretofore. t ; . f_ -1-4080/Do yen think it still may oocur?--If there is ? -dust, oertainly. -- .. . 7 | _-j. 4081. Have you any doubt in your mind that asbestos | dust does cause fibrosis?--I think there is no doubt 4 /'it did in this one case. ... - } l /.- 4082. Can you tell the Committee the particulars '6f -that .case?--The patient 'was a inan 33 years V ^ /of atro.'. He had been at work some 14 years. ; 1-lhe .first ter. of which he was in what wa6 called .N -.-thj carding room,"which he said was the most risky $ . `part of the work. He volunteered the statement that _ of the 10 people who were working in the room whe-n he ; went into it he was the only survivor. I have no - evidence exoeot his war! for that. He said thev all _ -/diet somewhere about 30 years rf ago. After he had . ^ I been'there 10 years he was put into another room, where j /there wae much less dust During the latter part of ./ /5 the 30 years he had had two attacks of what were -diagnosed &s bronchitis, which incapacitated him for *x a few weeks. In ISC-9, after he had been a: work some 13/!'r^`34:years he-vas *e3r-w-ni6,and^Jound he. hac_ "T"'*! Iriarkdd/pulmonary fibrosis, which was more like -'~y _ rotterjLaslhir.aih3a_ari.Tthjnz.els.I had seen. _ ' 4085. Were there any tuberculous sympioius- `--Nu ; tiiere were enlarged glands in his neck, bur they wore not tubercuioui. 4086. If, after hit first attack he had not gone back to liis work, do you dunk lie would have survive] ?-- That I can hardly say, because his firs: anaek uf sorailed bronchitis was some years before I saw him. The disease was so far advanced when I firs: saw him that it was simply a matter of time. 4087. (Profr^'fir AMbutt.) Will you describe what you found on examination of the lungs?--Tlmy were ex tremely tough and fibrous, especially the lower parts- 4088. IVhat was their colour?--In pans & greyish. black. 4089. Were there large and visible strands cf fibretraversing the lung, or was it & finer fibrous pene trating in ail directions ?--In the lower part the changn was uniform, about the centre the grev area- -were intermingled with reddish areas contatmnz some air. Jn the upper part th*-r was comparatively little change except increased toughness. 4090. Was there much pleuritic adhesion?--Yes. 4090*. Did you so further into any minute examina tion by mi'Towope- or otherwise?--Yes. I h.w- here som<- photographs which were takn under [if. Iy-ect's direction from specini-.-ns prepared for me bv Dr. Ifosanquct. ' 4091. (Dr. l./ijnr.) Can you tel] th* Committed what 1 asbestos is'--Jr consists chiefly of magnesium and silica with siiur iron and lime. 4092. (TrofriAnr Jl/lmtf.) Are'these spicu)os spiculee of asbestos?--Yes. --- 4. .Hr. n. x. . . - 4 if vri ii ij, M.l> 12S . MINUTES OF EVIDENCE: 4C03. Was there much dilatation of the bronchial tubes?--Not much. 4054. Might asbeslos be found in the sputa?--Yes; Yes. When this man first came u> the hospital he only complained of shortness of bri-ath. His imiso was 63. and hi* respirations were 23. we examined th>' spurn and found d-'hn-.u- c*"st, Vat ' e-'-uld not definitely dijtinguish it from other dust of similar character. 4099. bo that- it is in accordance with your expert ence that there is something characteristic about the far greater incapacitation of the patur.t than the com 4095. Were `.hero, no chemical means of distinguish ing it?--No, because in ganister disease there might be as much 6ilica in the lungs. Portions of tlie Jungs were analysed afterwards, but the analysis did not give paratively few physical signs wouij account lor 1--Yes. 4100. Docs v.-ur case illustrate this general rule?-- Yes. any further assistance. 4101. (Dr. I.r/7'!.) 'Was the sputum examined for the 4096. Tlic-rc would be then-ns^SiSruIy method at the service of a medical referee, would there, of deciding pri-sciio of tubercle bacilli or not?--Yes. None .were found. ,' at by the sputa whether a person was suffering from asbes/'S i.brosis or not?--I doubt it; I never heard of 4102. Did the condition of the lungs on the pootxnortein examination suggest any tubercular cavities?--_ any. No. 4037. From your experience in that particular case, 4!G3. In your experience at Charing Cross Bosp::al do you think by examination of the sputa you could have vou come across cases arising from any other durty distinguish another case if you came across onf ?--No ; occupations which showed symptoms similar to these ?-- one could c*e a probable diagnosis, but could not be NV precisely the .atne ; I saw two or throe cases sotT.e definitely certain the disease was not due to some other years aeo arising from brass <h:s*. in which there wore form of siliceous dust. nn.rh the same sympt-ims, but the diM-ase ran an _ 4^8 We hive hi-cn told that there is somethin? characteristic in Ihe earlier stages of dust-phthisis in fli'uit" cour-i-. *** 4104. Sooa'sinc c-noraliy, fibroid phthisu?. 6Ueh f ____ tli* predominance c-f shortness of breath^befure pJ/i*u:aI^.^hu.-as.jiOU-o:- n-*evii a-Loi.d.-ii-J^piials, is i: .-: `r^""'k1fin5Tjecoh!t` Very|oImous ; was tlis't the caso here?-- ^ That is so."^ ' -*