June 10, 1921] 



SCIENCE 



537 



workmen ... by sensible observance of the 

 facts and teachings of physiological science." 



The authors form a i)eculiarly authoritative 

 combination. As late H. M. Medical In- 

 si)ector of Factories, member of the Health of 

 Munition Workers Committee and Director of 

 Welfare and Health under the Ministry of 

 Munitions, Dr. E. L. Collis brings to his 

 task an unusual background of practical ex- 

 perience in preventive medicine and industry. 

 Dr. Major Greenwood is probably the fore- 

 most British medical statistician. Both au- 

 thors are members of the Industrial Fatigue 

 Research Board. 



The book is divided into four parts. In the 

 first section an historical review of British 

 industrial conditions preceding the eighteenth 

 century is followed by an account of indus- 

 trial legislation from the famous Ordinance 

 of Laborers in 1349, following the Black 

 Death, to the recent (1911) Coal Miners Act 

 and Workmen's Compensation (Silicosis) Act 

 of 1918. The first section closes with two 

 valuable chapters on the utilization of statis- 

 tical methods in industrial preventive medi- 

 cine and the effects of industrial employment 

 upon health as indicated by vital statistics. A 

 study of the mortality and accident rates in 

 the English coalfields has brought out a most 

 suggestive correlation between the percentage 

 of miners who voted in favor of a general 

 strike in August, 1920, and the regional 

 mortality distribution. In Nottinghamshire 

 where deaths and accidents are at a mini- 

 muatn, only 55 per cent, of the miners favored 

 a general strike while in Lancashire where 

 conditions are the worst of any English coal- 

 field, unrest was likewise at a maximum since 

 89.7 per cent of the miners voted to strike. 

 These figures indicate a deep-lying relation 

 betwen social unrest and health conditions. 



In the second part of the book a chapter is 

 devoted to each of the following subjects: 

 Fatigue, tuberculosis, cancer, accidents and 

 the industrial employment of women. 



No matter in the whole field of indusitrial hy- 

 giene is of more fundaimental importance than the 

 oeourrence of faitigue. Researches . . . into the 

 way in which the buman maxsHne worlis, are show- 



ing thait optimum output is obtained by not allow- 

 iag fa/fcigue to exceed physiological limits: that 

 the goal of the economist — output — can be test 

 aittained through the same agencies as allow the 

 medical man to oibitaiu his objective — ^health. 



The authors place little faith in the so- 

 called direct tests for fatigue and caution 

 against conclusions regarding fatigue that 

 have been drawn from output, sickness and 

 turnover figures, except in cases where work- 

 ing conditions are remarkably uniform. 



The problem of industrial tuberculosis is 

 summed up as follows: 



Not through amy special intensive measures of 

 campaigning against ithe tubercle bacillus, not 

 even by the segregation of the actively tubercu- 

 lous, does there seem any real hope of salvation. 

 We have to improve the homes of the working 

 classes in the first place — it is a sound popular in- 

 stinct that inspires the popular outcry against 

 urban and even rural housing condittons : in the 

 second place, we have to ensure better factory 

 conditions. We require regulations of the hours 

 and int«nsiity of work, of the physical characters 

 of the aitmiosphere, and of the quantity and qual- 

 ity of the meals taken, so that the workman re- 

 turning home shall not reach it in a condition of 

 definitely lowered reaiatance to an infection which 

 must stiU be regarded as ubiquitous. 



Palihological fatigue, inadequate ventilation 

 and insufficient food are believed to be the 

 three outstanding disposing factors to tuber- 

 culosis among industrial workers. 



Although tuberculosis has been steadily de- 

 creasing, " the sudden change which has taken 

 place in the conditions of life consequent 

 ujwn the development of modern industry, 

 has been associated with a rapid rise in cancer 

 mortality, and this rise is greatest where 

 modern industry is most developed." In a 

 selected group of occupations (1900-02) the 

 mortality from cancer in England and Wales 

 was greatest among chimney sweeps and sea- 

 men and least among farmers and grocers. 

 Chimney sweeps' cancer seems to be directly 

 associated with their occupation; in Belgium, 

 where coal like English coal is used, there is 

 almost complete immunity, but great care is 

 taken to prevent contact with soot. No ex- 

 planation is offered for the increasing cancer 



