In modern brick works the bricks are no longer wheeled on barrows from the presses to the kilns, but are taken either by conveyor or on power-driven trolleys and trucks. This innovation has done away with the labour of many setters. In one works the trolleys of green bricks are taken through tunnels in which they meet a current of hot air, and so receive their first drying during transportation.

In several foundries automatic moulding machines are used. These machines pick up the sand from floor, sift it, and deliver it with such force into the moulding boxes that no further ramming is necessary.

In one foundry where such a machine is used, the moulding boxes after being filled with sand, are placed on trucks running on a circular track and pushed to the pouring point. Molten metal is brought to the pouring point by an overhead runway and run into the mould. The trucks are then pushed round the track and the moulds broken. Casting by this method is practically continuous; the trucks in use being kept constantly moving round the circle.

Amongst engineers modern devices for increasing efficient working the following have been specially mentioned. Chucks which by magnetic attraction alone hold heavy steel objects in place while they are being machined. Ball and socket grip vices which allow articles to be held in the most favourable positions for working upon them. Special attachments for vertical drilling machines, by means of which small screws are supplied and fitted into small component parts. Automatic feeding devices for filling ball races, which make it possible quickly to separate a number of balls, and to count them as they drop one by one into the ball race. Automatic power presses which by means of mechanical feeding and multiple tools convert strips of metal into finished articles.

A simple and ingenious device seen in a tinware works might with advantage be adopted elsewhere. The soldering irons in this works are supported by means of coiled springs from a wall at the back of the soldering bench, one end of each spring being attached to a wooden plug let into the wall, and the other end to the soldering iron. The attachment of spring to soldering iron is so arranged that when left alone the iron rests at an angle of 45° just clear of the bench; a most convenient position for instant use. After use, when the handle is released, the iron swings back to its original position. This arrangement obviates much lifting and putting down of the iron during the course of a day's work.

Several labour-saving developments have lately taken place in potteries. In one pottery a rotary kiln has been installed. This kiln not only does as much work as six ordinary kilns, but does it with a considerable saving of labour, time and fuel. In another pottery the installation of a tunnel-drying system has entirely done away with the carrying of articles by hand to the

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drying room, and thus freed a number of young girls for other work. While in yet another pottery the introduction of a reversible lathe has done away with the necessity for a lathe treader, and is said to be giving every satisfaction.

In several weaving sheds the lifting and moving of loom weights has been obviated by the introduction of various patent appliances. With these appliances, instead of having to lift heavy weights on or off, the tension of the cloth may be altered by the turning of a screw, thereby effecting a great saving in both time and labour. Managers and overlookers of factories using these appliances speak very highly of them, both as manufacturing and labour-saving devices.

Conclusion. The general effect of the introduction of the appliances herein described has been a great saving of labour, much of it of a strenuous and arduous nature; more efficient and economic working; and a material reduction in the risk of accidents.

CHAPTER IV.

REPORT OF THE SENIOR MEDICAL INSPECTOR.

John C. Bridge, F.R.C.S.E., M.R.C.P.E., D.P.H.

A report dealing with the Medical Inspection of Factories would be incomplete without reference to the resignation, in November last, of Sir Thomas Legge from the post of Senior Medical Inspector of Factories. Sir Thomas Legge was the first Medical Inspector of Factories in this country, which post he held from 1898. It is not too much to say that his guidance, particularly in framing regulations dealing with dangerous trades, has been of the utmost value in safeguarding the health of the workers in these trades. The result of these regulations in diminishing the incidence of industrial disease has been shown year by year in his reports, and his resignation marks an epoch in the history of Medical Inspection of Factories.

This report on the work of the Medical Inspectors during the past year follows the usual lines. Much of the work has been of a routine character, though interesting and useful inquiries into special problems have been made. The Report of the Departmental Committee, appointed to consider evidence as to the occurrence of epitheliomatous ulceration among mule spinners, to which Dr. Henry acted as Secretary, was published in February.* Dr. Henry has continued to follow closely cases of epitheliomatous ulceration of the skin, either notified to the Department or from information obtained from other sources. The analysis of such cases is given later on pages 89-90. The information Dr. Henry has obtained is of considerable value, not only as regards the specific question of cancer among mule spinners, but also as it affects the larger problem of cancer and its causation amongst the general population.

Dr. Henry took part in conferences between employers and employed in the cotton trade, with a view to a better organisation of First Aid in cotton mills. It will be readily appreciated that, though a standard for First Aid equipment can be prescribed for factories in general, the organisation of such equipment must vary according to the requirements of a particular industry. The example of the cotton industry in an endeavour to standardise the organisation of First Aid might well be followed in other industries.

Dr. Henry has also been instrumental in arranging for the periodic medical examination of workers, not required under regulations, in three factories, where his inquiry has shown that

* Report of the Departmental Committee appointed to consider evidence as to the occurence of Epitheliomatous Ulceration among Mule Spinners, 1926. (27385)

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such an examination would prevent the occurrence of an industrial disease. Thus, for the workers in the anthracene department of a large chemical plant, a quarterly medical examination has been instituted; similarly, a medical examination at the same intervals has been arranged in a chrome recovery plant and in an electric meter repair department.

Dr. Middleton has again been much engaged in special inquiries in connexion with silicosis and, in particular, has made a preliminary survey of the stone-working industries so far as they relate to work on stone containing considerable proportions of silica. The object of the survey was to outline a scheme for a medical inquiry into the incidence of silicosis. For the purposes of this survey, he visited 82 quarries and 33 factories and yards in which stone was being worked. The survey was limited almost entirely to two classes of rock (1) granite and other igneous rocks allied to granite, (2) sandstone, including gritstone and siliceous freestone. The places visited were distributed widely over the country, from Aberdeenshire to Leicestershire. As a result of this survey, a suggested scheme for a medical inquiry was submitted on 25th October, 1926. Dr. Middleton states that, as a result of this inquiry, it is evident that mechanical methods tend more and more to replace manual work on stone, and there is an increasing amount of mechanical crushing plant on quarry premises for the production of road material. The conditions found at some of these crushing plants indicate that very large amounts of dust are produced. The use of pneumatic tools shows evidence of increase in quarrying and dressing of stone. In the process of dry drilling with pneumatic tools the worker is exposed to a considerable amount of dust. A large number of atmospheric dust determinations were made at the various processes in quarrying and dressing and crushing of stone, and the results, together with the clinical and radiological findings, should prove of the greatest use in arriving at an estimate of the effect on the health of the workers of exposure to dust in the different processes in the industry.

The inquiry into the incidence of silicosis in the potteries industries by Doctors Sutherland and Bryson was completed. under the supervision of Dr. Middleton and the report issued.*

Dr. Middleton visited Solingen during the year, and a short report on the conditions prevailing in the cutlery industry in that centre is given on page 94.

Dr. Overton has been more particularly engaged in inquiries into conditions of employment as they affect women and young persons, and in studying the question of industrial dermatitis, both generally and with special reference to certain trades, including a brief inquiry into the possibility of the spread of infection by the use of the common towel. Visits to firms included

Report on the Incidence of Silicosis in the Pottery Industry by Dr. C. L. Sutherland and Dr. S. Bryson, 1926.

those where several cases of dermatitis had been reported, and which were typical of various trades where dermatitis, often complicated by secondary septic infection, was fairly frequent. Thus, the manufacture of bread, cakes, biscuits, sweets and chocolates, together with the engineering trade, were especially selected for inquiry. Dr. Overton found that septic skin lesions may be a source of infection of one worker by another in the factory. The infection may be by direct contact, or by indirect contact through the media of tools or towels. Dermatitis is, however, not contagious when uncomplicated, but if neglected, secondary infection with septic organisms occurs. The transference of these organisms by whatever agent, be it by the medium of the common towel, the common tool, or by actual direct contact, would not result in a condition of dermatitis in the second worker, but in septic infection of the skin. From the brief inquiry the case against the common towel is yet "not proven," and positive evidence in favour of the spread of infection by this means, to the exclusion of others, is likely to be elusive.

During the year facilities were afforded to carry out pathological investigations at the Laboratory of the St. John's Hospital for Diseases of the Skin, Leicester Square. Dr. Overton has examined blood films from workers in lead, benzol, etc., and materials obtained during inspection such as dust, straw, grain, etc., have also been examined by culture experiments. In the case of straw which was obtained from the same source as that which had caused skin affection among two furniture packers, a member of the streptothrix group was cultured. In view of the relation between this group and the actinomycoses which cause woody tongue in animals and occasionally in man, this finding is of importance. The opportunity thus afforded for following up the work of inspection by a laboratory examination is obviously of great value.

The table on page 82 gives particulars of the incidence of industrial poisoning or disease now notifiable by every medical practitioner under Section 73 of the Factory and Workshop Act, 1901. Comparison in certain instances is made with previous years.

Lead Poisoning.-Poisoning by lead produces a definite train of symptoms, though in certain cases these may be illdefined. A worker exposed to lead has on more than one occasion been notified as suffering from lead poisoning which, on investigation, has proved to be a septic infection of an injury Such cases have been excluded in calculating the total number of notified cases, but a diagnosis such as this may lead to difficulty for the employee and employer. The decline in the reported cases noted last year, is continuing, there being 84 fewer cases than in 1925 and 244 less than in 1924. Some of this diminution is undoubtedly due to the adverse conditions of trade, although Electric Accumulator Works, from which 21 fewer cases of lead poisoning have been

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