Hard rock miners' phthisis in 19th and early 20th century Britain: From diagnosis to compensation.
详细信息
文摘
The present study examines the elaboration of silicosis, the disease, and the development of social policy directed at its prevention and compensation in Britain from the 1830s until 1918. I concentrate mainly on the nineteenth century and the twentieth century until 1907. In 1907, the law recognized that an occupational disease was a notional injury and a few became compensable. Both the etiological elaboration and prevention of silicosis, and, ultimately compensating its sufferers occurred over a very long period. My major subject is the causes of this time lag. While some investigators have alluded to the early public health emphasis on worker well-being, I also address how occupational health became a secondary consideration for most of the nineteenth century, despite its promise of achieving as much as "Chadwickian" sanitation, at much less cost. The government created commissions and committees to learn more about occupational health conditions. However, it appears that it offered these, without much intent to follow through, but rather, as a temporarily sop to placate those with a special interest in the subject. This work studies in more depth than others of which I am aware, the 1862-64 Commission of the Condition Of All Mines In Great Britain To Which The Provisions Of The Act 23 & 24 Victoria Do Not Apply coal mines). During those proceedings, I found that the etiology and partial prevention of silicosis were clearly established. This information was relegated to the blue books for reasons that I also investigate. When interest in silicosis revived, there was little or no reference to this work. Students of the subject have noted that in the 1880s British medicine was anecdotal and derived from experience in private practice. I have attempted to show how this influenced the elaboration of a specific disease, silicosis. In addition, medical teaching, membership in societies and with an interest in some aspect of medicine, very likely, what submissions were accepted to medical journals as well) were controlled by a metropolitan medical elite with little or no scientific, social or pecuniary interest in the diseases of miners. This view was transmitted to general practitioners as well. Another aspect of the present work, different from most, has involved a careful reading of all the issues of The Lancet and The British Medical Journals from 1864 through 1906. I found relatively few articles relating to silicosis, confirming that the readers level of interest was not very great. In addition to demonstrating a paucity of articles about miners lung disease, these journals also reported on the controversial role of tuberculosis in the elaboration of silicosis. Failure to scientifically address this debate significantly delayed compensating for and preventing silicosis. Additionally, I show that the journals revealed a terminological obfuscation that made the understanding of what silicosis was, very difficult. The science of statistics was in advance of other medical tools and did provoke some interest in silicosis but the journals and reports of the commissions also show how statistics were manipulated to minimize the incidence of silicosis. Moreover, organizations presumably having a keen interest in the etiology and prevention of silicosis and its compensation) were often, themselves, a source for the lag. These included unions, mine and quarry owners, both the Liberal and Conservative Parties, the public health establishment and, to a lesser extent, the mining and quarry inspectorate. This work shows that these organizations had distinctly different attitudes about compensation legislation than they held the in the twentieth century. In the process of arriving at the correct etiology of silicosis, and, as a result, whether it should be indemnified, all interested parties picked through what was on offer to patch together some commonality of position that had little to do with any adherence to an overall structure, coherency or rational knowledge. Inevitably, their motives were an admixture of highly parochial and shortsighted deliberations and considerations that were more altruistic. Any attempt on the part of various parties to act in unison was a material and a practical matter and had little to do with systematic logic. The authority of the interested organizations related to the power that sustained them and to what was required to disrupt them and bring about fragmentation. In this process, as Bruno Latour has pointed out, the content of what was achieved, always involved fusion with the context. This work concludes that when problems resist timely solutions, the reasons are always multiple and that they shift over time without result until a reconciliation of various social and cultural differences becomes possible. In fact, reconciliation did occur despite the fact that the motivations of the negotiating parties were contradictory. Abstract shortened by UMI.)