60 DR. MooRs. on Inju,'ies from Flax Mills.

Before closing my observations, i would remark that the diagnosis of these two diseases has been obscured by the fact, that not u~frequently we have loss of motion of the lower limbs where we have least reason to expect it, viz. in the func- tional affection. I have a distinct recollection of a man, and not a very imaginative one, who was admitted into hospital, having lost the use of his limbs. He went upon crutches. He de- scribed a kind of fit, which he said seized him daily, and which he represented as. a kind. of aura .rushing up from. the stomach to the head, after which he got into a state ot uncon- sciousness for some time. He was quite aware of the fit coming on. I ordered for him an antispasmodic draught, composed of camphor, ether, and ammonia, with directions that he should take it immediately when he felt the approach of the fit. He only took three draughts when the fits quite ceased, and he immediately recovered the use of his limbs. He went out of the hospital, and, having no further occasion for his crutches, left them behind him.

The preceding observations have been put together as a contribution of pathological material bearing upon some of the most interesting and important points in theoretic and prac- tical medicine, viz., the physiology and pathology of the ner- vous system--a system whose investigation is attended With more difficulty thanthat of any other in the animal economy, and a knowledge of ,~ hich must constitute the very fbundation of medical science. Its difficulty and importance should sti- mulate our endeavours by every means that afford us the least hope of either directly Or indirectly obtaining our great object. I entertain the most sanguine expectation that the results of anaesthetic remedies will contribute much towards this end, as I think I have proved that other therapeutic agents have cleared up and established the true nature of not a few patho- logical conditions to which they were applied, and wrested them from the obscurity which surrounded them.

AnT. IV . - -A Notice of some Cases of Injuries produced by t]~e Machinery of Flax ,Scutch Mills. By WILLL~ MOORE, A. B., M. B,T. �9 C:D..,L . . . . R C S ..I, Surgeon to the Ballymoney Dis. pensary District and Bndewell.

ACCID~.NTS Of the above description have, as regards Ireland, been hitherto almost exclusively confined to the northern dis- trict, inasmuch as it has been the great field for the promotion of the growth of flax in this country: however, it is now be-

Da. MooaE on I]~juries f rom Flax Mills. 61

coming a more staple commodity, being more generally cuhi- rated over the length and breadth of the land, as the following extract from the last Report of the Royal Flax Society of Ire. land shows'--": In the present, year there were 175,495 acres under flax m Ireland, being an increase of 29 per cent. over last year's crop. The increase in Leinster, Munster, and Connaught is 22 per cent. over last year, the amount of acreage under crop being 14,279." Injuries similar to those I am about to describe, no doubt, will be more or less entailed there- by on the inhabitants of those provinces, but I trust not to the same extent as has hitherto occurred in Ulster, where it is mainly owing to the question of perfection in the manufacture of the raw material being made of primary importance,--that of the frightful mutilation and frequent loss of life, from the imper- fect construction of the machinery, of secondary import. -

In order that my readers may the better Understand how accidents are of such frequent occurrence in these scutch mills, I shall give a brief and, therefore, rather imperfect de- scription of the dangerous and exposed arrangement of the machinery in the majority of these mills. In the old flax scutch mills, large wooden rollers are used for the purpose of bruising the fibre, and these are kept supplied by an attendant ~who is strapped to a staple at a certain distance, to prevent his being drawn into the machinery, and who opens the bun- dles of flax and suits it to the rollers. From the slightest inattention, the hand, under any circumstances so contiguous to the rollers, is readily drawn in with the flax, unless the pre- caution of the strapping is resorted to, and the loss of a limb, or, as too frequently happens, of llfe, is the consequence, as is shown by my third case. This imperfection is remedied to a considerable extent in the more recently constructed mills, in which there is a table, at one extremity of which the rollers are fixed, and at the other end the attendant stands and ar- ranges the flax, consequently he is at a considerable distance from the rollers. The accidents from being caught in rollers are not so common as heretofore, owing to this recent improve- ment, which, I regret to say, is not sufficiently general, at least in this locality. The flax when rolled is subjected to the scutching machines, and these, even in the most recently con- structed mills which I have had an opportunity of examining, are most imperfectly planned, as far as regards the safety of the men in attendance in this particular department, as ~is clearly proved by the frightful mutilation and loss of life whicht I might, almost say, occur daily. The seutching appliances are, as it were, wooden wings, attached to a shaft at certain

62 DR. MOORE on Injuries from Flax Mills.

distances, and driven with considerable velocity ; opposite each of these scutehing machines there is an aperture where the scutehcrs stand, and their office is to subject the rolled flax as equably as possible to the action of this machinery. The hand is not more than a few inches, say two or three at most, from the machi.nery, and consequently comes in contact from the least inadvertence, and a lacerated wound or loss of the limb is the consequence.

The first case-I have to report is that of R. C., aged about 55. In the month of November, 1852, I was sent for to visit this patient, and found him suffering from a fracture of the met'acarpal bone of the index finger of the left hand, and a la- cerated wound of the thumb, index, and middle fingers, the muscular substance was torn off the thumb, and the bone and extensor tendons were denuded. The wound of the fingers extended over the back of the hand. Under the use of cold water dressing, with oiled silk, and the occasional application of a linseed meal poultice, when the suppuration was profuse, the wound healed rapidly. In this case the patient s attention was casually distracted from his employment, and his hand came in contact with the scutehing machine.

CAsE II .mA. M'H, aged 45, inadvertently placed his hand too close to the scutch wings, and received a large flesh wound, which extended diagonally across the back of the left hand. The bones were uninjured. Cold water dressing, as in the previous case, had a most happy effect in healing the wound.

CAsE II I .mOn the 30th of March, 1853, I was sent for to see S. O., aged 40, and found his jaws so locked that the point o~ a penknife could scarcely be passed between his tecth~ rigidity of the masseters and of the muscles of the back ; neck curved backwards, frothy saliva exuding from between the teeth; frequent severe paroxysms. All these frightful symp- toms had supervened on a lacerated and contused wound of the right arm, extending from the tips of the fingers half way up the fore-arm, which had occurred on the 22nd inst., eight days previous to my seeing him. Notwithstanding the use of warm baths, turpentine epemata, and the exhibition of calomel and Dover's powder every second hour, as lung as it could be in: troduced betwee n the teeth, the patient died on the following day. In this case the patient had not taken the precaution of having his arm bound to astaple to prevent its being caught in the rolling ,machines, and consequently he received the mortal injury I have described above.

CAsE I V . ~ O n October 3rd, 1853, I first saw this patienh and found a compound fracture, of both bones of the left fore-

Da. MooIt~. on Injuries from Flax Mills. 63

arm ; there was no protrusion of the bones through the wounds. I placed, the arm. on a pillow, and applied cold water dressing and ruled cahco; the wounds healed favourably. November 4th, I put the arm up in two straight splints, and on the 29th I removed both splints, when the arm was perfectly straight.

In this instance the patient, while carrying a bundle of flax, tripped up and fell, his left arm coming in contact with the scutching apparatus, which instantaneously inflicted the above injury.

CASE V.wM. M'M., aged 40. This was a contused wound of the left hip, and a transverse lacerated woun d of the adductor muscles, about three inches across and of considerable depth. The woman stated that her clothes caught in the rollers, and she Was gradually being drawn in when the mill was stopped. She supposes the deep wound was caused by the cog-wheel of the rolle~rs. Treatment Consisted i n the application of cold water dressing covered with flannel.

I could cite innumerable instances of similar injuries which have occurred in the practice of my neighbouring professional brethren, and in which the loss of one or both arms was the consequence,--death being the termination in many cases. The most formidable sequelm in these injuries are tetanus, trismus, and mortification; consequently the employment Of lint, bandages, and plaster dressings, which become dry and irritating, are particularly ill-suited for such injuries as I have described, in which there is severe nervous laceratibn. Cold or tepid water-dressing, covered with oiled silk, constitutes the most sedative and grateful treatment, and is easiest applied. In the majority of cases colcl water is the most salutary appli- cation, inasmuch as it checks the hemorrhage, which is consi: derable in all these wounds, excessive in some. Where there is an extreme morbid sensibility in tt/e injured part, tepid wa- ter, at a temperature between 85 ~ and 90 ~ Fahr., may be more soothing. When the suppurative stage commences I employ linseed-meal poultlces, as they clear away the discharge more speedily ; but once this diminishes I return:t0 the cold Water, to complete the healing process, which it invariably effects in an incredibly short time. O n the whole, I consider there is no other treatment so well suited for such injuries, as, by keeping the parts moist, the morbid irritation in the injured nerves, which the dry dressings are so apt to excite, is allayed, and the fearful and intractable sequences mentioned above con- sequently anticipated.

Before concluding these remarks, I cannot help adverting to the absence of that due regard for the preservation of human

64. DR. ~Io0~ on Inj~ri~es from Fla,v Milh'.

life which seems to prevail so generally in the manufacture o{' flax. In this trade the motto seems to be, " Salus populi ul- tima lex," as may reasonably be inferred from the subjoined extract from the Report of the Flax Society on scutching ma- ch ines : - " From what they have witnessed, however, they believe that they shall have ere long to report upon a progress more or less complete towards the establishment of a process which shallbe to a certain extent self-acting,--that conside- rable improvement will be thus introduced into the scutching process; tending towards economy of labour an~t ~ increase of yield." Here the virtue of the machinery l~eing self-acting s-eems to consist in "economy of labour and increase of yield :" the '! salus.populi" is not once even hinted at.

In an admirable Report of the Dervoek Dispensary, by the Rev. Thomas Hincks, I find the following paragraph : - - The Committee feel called upon to direct attention to a Report ot ~ their medical officer, in which he states that scarcely a season has passed in the course of his practice without accidents, more or less severe, happening to persons from the bad construction of flax-rolling mills, whereby in some instances fingers, in others a hand, and in others an arm, have been lost: thus dis- abling the sufferers for life from using any industry, and gene-

"rally causing them to become burdens upon the community. Two such instances have occurred in this district within the year; and the Committee cordially concur with their medical officer in recommending that some legislative enactment should "be sought for, to place these mills under proper super. vision."

Now, b~r the return of the Census Commissioners, it ap- pears that last year there were 956 mills at work in Ire- "land, employing 15,000 persons: many more have since been erected, particularly in the south and west of Ireland, and, .under these circumstances, it is high time that some decided steps should be taken in the matter to prevent an extension of those injuries, which heretofore have been almost exclu- sively confined to the province of Ulster, and which, in the majority of cases, either ierminate the sufferers' existence, or maim them, so that they become helpless for life.