Why Workers in the Silver Trade Died Early

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dognose
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Why Workers in the Silver Trade Died Early

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Charles Turner Thackrah (1795-1833) was a Leeds surgeon and a pioneer in the field of occupational medicine. In 1832 he published ‘The Effects of Arts, Trades and Professions and of civic states and habits of living on Health and Longevity with suggestions for removal of many of the agents which produce disease and shorten the duration of life’ This work prompted the introduction of the Factory Act in 1833.

The following are his observations on those connected with the silver trade.

Workers In Gold And Silver have different degrees of muscular exertion according to their departments. In the process of casting and moulding, the men have moderate exertion, and generally stand. The slight dust which arises from the charcoal or brick-powder, does not produce apparent effect. In the chasing, hampering, mounting, and pumicing the workmen sit, and are, in consequence, considerably more affected with disorder of the digestive organs. In the hampering, where they are obliged to lean much forward, the men are decidedly paler than in the mounting, where they sit upright. In the polishing they have an alternation of sitting and active exertion, for while one man turns the wheel to which the brush is affixed, the other holds the article to be polished. The men appear more robust in this, than in most of the preceding departments. Stamping, effected by raising a great weight and then allowing it to fall, is a laborious process. Each man is supposed to lift 80lbs. 500 times a day. In most of the rooms charcoal is burnt, but its gas does not produce a sensible effect, except when the apartments are low and the roofs of the common, instead of the pottery form. The "blue vapour" in this case affects respiration at the time, and establishes a morning expectoration of mucus. In no department are the men crowded. Workers in gold and silver earn good wages, live well, and are not generally intemperate. In the department of stamping, which occasions profuse sweating, we find the men to take each during the day about three quarts of porter, twice the quantity consumed by individuals in other departments. It does not, however, seem to be injurious. The stampers were the most healthy men in the great London -house we examined. In no department did we find aged operatives; but this seems to arise rather from the preference given to young men, as more expert in the improvements of the art, than from any thing baneful in the employ. A master of 12 or 16 working-silversmiths has since informed us that he has two or three between fifty and sixty years of age, and that, on examining a club of 100 men, he found as great a proportion of aged, as town-life commonly exhibits. He makes some general remarks, which I beg to insert in his own words,–" Their habits are various, say two of every dozen are rather abstemious, taking about a pint of malt liquor per day, and spirituous liquors not once a month, and live regularly; eight of the same number are men who live well the first four or five days in the week, that is, eating meat two or three times a day, and drinking perhaps from two to four pints of beer. They then appear dull and heavy, but in the last two days they ' study Abernethy,' as we say; take perhaps no meat, and water instead of beer, which makes them as cheerful as possible, aided a little by the idea of being near the eating and drinking days. The remaining two, or one at any rate, is a regular drunkard, taking from four to eight pints of beer per day, and perhaps three or four glasses of spirits in the same time. Some of this class die at 30, but others are in the workhouse, and live to 50 or 60."

Gold-beaters have an employment distinct from the preceding. They are engaged above half the day in beating the metal with heavy hammers, and the rest in spreading the gold leaf on paper. The process affords, therefore, an excellent alternation of labour and comparative rest. The men exposed to no injurious agent, and enjoying good wages, are healthy and robust.

Workers Of Tortoise-shell have an occupation sedentary, but not otherwise injurious. The dust which arises in drilling is too slight to affect them.


Engravers fix the trunk and limbs more than almost any other operatives. The head is brought forward, and the eye intensely and long occupied with objects generally so small as to require a strong artificial lens. In one part of the process, the engraver is subjected to the annoyance of nitrous fumes, but this is only occasional. The posture and confinement affect the head, but more frequently, and more considerably, the organs of digestion. Sometimes the appetite is reduced, almost always the action of the bowels is greatly impaired. Organic diseases, however, of the abdominal viscera are by no means so frequent as in many other sedentary occupations, tailors and shoemakers for instance. This I attribute to the less general intemperance of engravers. The employment affects vision. Young men, for a short time after removing the lens, are unable to judge accurately of the relative size of objects, even at a foot's distance. And the eyes of old engravers are considerably impaired, both as optical and vital instruments.

Mr. B., now about the age of 60, was closely employed in engraving for 30 years. His right eye, that which he applied with a convex lens to his art, is considerably more prominent than his left; and he is consequently obliged to close it when he looks at distant objects. Though not of late years engaged in engraving, he cannot accurately estimate the distance and relative position of near objects. In playing at backgammon for instance, he frequently takes up a wrong marker. In weak light, the left eye is better than the right. Cases of this kind illustrate some points of function and disease.

Clockmakers have little objectionable in their occupation ; for though the making and fitting-up are carried on in the house, the posture is varied, and the men are frequently travelling to repair clocks in the country. They are generally healthy, and attain often advanced life. Watch-makers have a much worse employ. They sit all day with the trunk bent forward. The digestive organs almost always suffer, and the lungs are sometimes affected. The close and continued application also greatly injures the eyes. Many youths apprenticed to watch-making are obliged to leave the employ, and the individuals who remain rarely live to old age.

Wire-drawers are in an atmosphere disagreeably impregnated with the odours of tallow and oil, and with the exhalation from the sour ale-grounds, in which the cylinders revolve. The general health, however, does not appear to suffer. Some men have contraction of the fingers. This they ascribe to the sulphuric acid employed ; but a more probable cause is the flexed position, in which the fingers are kept in handling the wire.

The Makers of Military Ornaments at Birmingham have various occupations, several of which are injurious. In bobbing, some of the articles produce much dust, and proportionally excite sneezing, cough, and difficulty of breathing. In turning, the small wheel, covered with emery, throws off sparks of fire, which entering the throat, cause a warm sensation in the chest and stomach. In filing, the particles detached are larger, and consequently do no injury. Lackering is considered by the women who perform it, unhealthy; but the only results apparent are paleness and loss of appetite. No person is confined to any one of these processes, and hence the effects of each are not marked. The operatives do not commence work till eight in the morning. Generally temperate, they live to age.

Metal Spoon Makers are subjected to some fumes from the melting of their materials; but temperate workmen enjoy health, and attain full age. We did not hear that the antimony, tin, and lead which they use, induce any form or modification of palsy.

Metal And Iron Button Makers are exposed in the casting department, to great heat and some dust. The fumes from the zinc produce occasionally that form of ague to which brass-founders are subject. The men, however, though pale, are generally healthy. In this, as well as in the preceding employ, scalds from the melted metal sometimes occur. In turning, particles of the buttons are detached, which frequently pass into the stomach or air-tube. For the gastric annoyance, the men occasionally take emetics. The irritation of the air-tube produces often more serious effects, bronchitis, inflammation of the lungs, and ultimately consumption. In grinding, smaller particles are detached, the atmosphere is consequently more clouded, and serious disease more frequently produced. The men who escape pulmonary disease, appear unhealthy, and are seldom able to remain at the employ after the age of 45 or 50. Their posture is leaning and confined ; and the opportunities which offer for exercise and fresh air, are often devoted to the destruction of health : Mondays and Tuesdays are spent at the alehouse. In finishing the buttons, the stone and sand powder does not foul the atmosphere, and hence urgent disease is not produced; but the rooms are small, and the operatives confined to a leaning posture. Men, boys, and females are employed. Though some in this department live to a considerable age; the general health in most of the elder operatives appears to be reduced. In the polishing, the dust is especially injurious, bronchitis is soon produced, and consumption frequently follows. In the varnishing department the operatives look pale, but seem to suffer only from confinement and the leaning posture.

Gilt Button Makers, in the casting department, are subjected not only to great heat, but to rather severe effects from the fumes of zinc. These are giddiness, headache, sickness, reduction of the appetite, and bilious disorders. The men have the appearance of ill health; 45 is about the average duration of life. In this, however, as well as other baneful occupations, it is difficult to determine the proportion of evil which the employ and intemperance respectively produce; for labour that distresses is generally well paid; high wages admit considerable intervals of rest and leisure; and leisure, by most uneducated workmen, is spent happily only at the alehouse. In gilding, the temperature of the rooms is 110° to 120°. But the principal evil is the mercurial vapour. Reduction of appetite and of sleep, trembling of the limbs, soreness of the gums, and disorder of the bowels are the common effects. At Birmingham, the women employed in this department begin their work at 10 a. m., and leave it at 5 p. m. They seldom live to full age.

Grinders of Sheffield. Dr. Knight, in the North-of- England Medical Journal, states that the fork-grinders, who use a dry grindstone, die at the ages of 28 or 32, while the table-knife grinders, who work on wet stones, survive to between 40 and 50. Dr. K.'s paper very properly alludes to the combination of injurious agents and circumstances. It is not merely the pernicious employment, but the want of sieve and ventilation in the apartments where the men now work,–the want, moreover, of that exercise in the open air which they formerly took in going to work and returning from it; and finally, the intemperance which results from their congregation, and still more from their desperation of life. It appears, that in 1822, " out of 2,500 grinders, there were not 35 who had arrived at the age of 50, and perhaps not double that number who had reached the age of 45: and out of more than 80 fork-grinders, exclusive of boys, it was reported that there was not a single individual 36 years old."
The symptoms of the grinders' disease are difficulty of breathing, such as to require generally the action of the muscles auxiliary to respiration ; tightness of the chest; hoarseness of voice, and tenderness of the larynx; sonorous cough; spitting of blood; expectoration of mucus, containing often dust, and, in the latter stage, of fetid and purulent matter; muddiness of complexion; anxiety of countenance; pulse quickened, not at first, but in the after stage; colliquative sweats and diarrhoea; emaciation;–in a word, the signs of slow but certainly fatal consumption. The remedies judiciously recommended by Dr. Knight, are, 1st. Dusting the machinery, before the work commences ; 2nd. Great reduction in the time of labour ; 3rd. Use of wet stones as much as possible; 4th. Large flues to be laid on the floor for ventilation, and currents of air to be forced through them by the machines ; 5th- Fork-grinding to be confined to criminals.

Makers Of Looking-glasses, or rather Men Who Silver Mirrors, are exposed, both by inhalation and touch, to the action of mercury oxygenized by the atmosphere. The operatives are chiefly Italians. Few can bear the employ daily for a long period. Some work on alternate days ; and many, more constantly engaged, are obliged from illness to be absent for weeks or months. An English master tells me that he has been in the habit of silvering mirrors, for two or three hours a day during the last fourteen years, and considers it remarkable that he has suffered, even from this short diurnal employ, no other injury to health than constant though not great trembling of the hands. The general effects of the art are difficult enunciation, pain and constriction at the base of the chest, emaciation, debility, tremors, and lastly salivation. The gums are often wasted and the teeth left loose in the sockets. As the fingers and hands are generally the parts first disordered, it appears that the primary impression is on the nervous system at large, and is made through the medium of the skin rather than that of the lungs.* Intemperate men suffer most.

" In the London Medical and Physical Journal, for November, 1831, is an interesting article on this employment, by Mr. Mitchell, of Lamb's Conduit-street, London. I extract two of the cases he relates :–

" Peter Cataneo, an Italian, had worked for five years at silvering mirrors ; during that time he had repeatedly been obliged to desist from his employment, until the effects of the mercury subsided.

November,1829. The tremors are general; gums sore : spirits depressed ; bitter taste in the mouth, which is also very clammy; tongue white ; temperature of the skin sensibly above the natural standard; pulse quick and small, but is with difficulty felt, in consequence of the constant tremor: he likewise complains of cough and tightness. He took the sulphur, as recommended by those who have practised at the mines, with some degree of benefit; a grain of opium at bedtime ; and his subsistence consisted of milk, gruel, fish, and porter. He used for the sore mouth an acid gargle. The ptyalism abated ; the tremors subsided, and in the course of a fortnight, in a great degree, vanished ; leaving, however, behind a great feeling of weakness, which was successfully combated by nutritious diet and bark. The injunction never to resume the employment of silvering had no effect ; but he has since, I understand, been obliged to relinquish it.

P. Nash, aged twenty, of nervous temperament, commenced silvering six months ago, the trembling came on three days after he began to work, and his mouth was sore in six days; and he has continued to suffer, more or less, up to the present time. 14th March, 1831 : The speech greatly impeded ; the limbs totter when he attempts to stand or walk, which he accomplishes very slowly and with great difficulty, an infirm step, and awkward gait; he is unable to convey any substance to the mouth, in consequence of the severity of the tremors; slight subsultus tendinum, confined the upper extremities; the tongue quivers, gums slightly tender ; pulse strong, rather quick ; appetite diminished ; sleep disturbed; body wasted ; he complains as if a feeling oppressed like a load across the lower part of the chest; or as if a substance lay at the bottom of the lungs, as he expresses himself, which he conceived to have been drawn in by inspiration; the breathing was quick, accompanied with strictured feeling and cough. He was nearly thrown from a bath by the violence of the trembling ; a large quantity of the water was driven by his excessive agitation over the sides of the bath ; and if two men had not held him steadily in the water, he must have been thrown out before he was capable of remaining quiet."

Mr. Mitchell remarks that in twelve looking-glass manufactories he visited, "it clearly appeared that the metal became oxidized, by combining with part of the oxygen of the atmosphere, and the more quickly so from the friction which is necessary in the application of the quicksilver to the plate of glass."

The French see much of this disease, and call it Tremblement des doreurs, or Tremblement mercuriel. Merat has paid particular attention to the subject, and Patissier enters on it at large; but after the details already given, I need only remark that they dwell especially on the nervous diseases in. duced, the convulsive motions of the muscles so universal and urgent, and the occasional occurrence of somnolency and delirium. Sometimes the men, from their inability to direct their hands with precision, are obliged to feed like quadrupeds.

* The superintendent of a manufactory told us, that from the sweeping of the chimnies on one occasion, he collected twenty pounds of good quicksilver.

Water-gilders, men who coat silver or other metal with an amalgam of gold and quicksilver, are exposed to the same poison as the silverers of mirrors.* They diminish its effects, however, when employed on small work, by interposing glass between the mouth and the materials; and when engaged on larger articles, by affixing to the mouth and nose a kind of proboscis, which hanging down, opens at a distance from the source of the mercurial fumes. Notwithstanding these contrivances, and every attention paid to ventilation, the art cannot be closely pursued without the induction of serious disorder. Depression of spirits or " nervousness," is succeeded by trembling, sickness, depraved taste, fetid breath, and finally salivation.* Palsy also is frequent; but this, as well as the other maladies, is in most cases removed by rest and fresh air. Repeated attacks, however, destroy vigour of constitution and shorten life. Men past middle age suffer so much more than others, that scarcely any are found at the employ. Water-gilders generally work but four days a week, and for about nine hours each day.

Personal cleanliness and change of dress considerably diminish the bane of this and the preceding employment. Ventilation also, and the management of currents of air through the workshops, should be regarded as much as possible.t When tremors appear, rest, fresh air, and aperients should be promptly employed; and for salivation, I have found opium the most efficacious and speedy remedy.

Jewellers And Workers in Gold, a distinct class from that of the Silver-workers, are subjected, not only to the evils of confinement, but to the effects of gases evolved in the manufacture. These are, the gas from the coke employed, as in collecting the gold from the sweepings of the floor; the gas from the charcoal used in melting; and the vapour, which arises in the process of dry colouring, from the fusion of saltpetre, alum, and common salt. The last produces such distress in the head and nervous system as to make it particularly disliked by the men. Wet colouring, in which mineral acids are used, I believe, is comparatively innoxious.* The jewellers' work-rooms are generally crowded, and the atmosphere consequently fouled by respiration, animal effluvia, and the smoke of lamps, as well as by the specific exhalations of the manufacture. Its temperature is generally raised, and in summer the heat is excessive. The labour is light; but the confinement to a leaning posture, with the head much depressed, and the elbows generally fixed to the sides of the trunk, for ten, fourteen, or sixteen hours a day, is irksome and injurious. Intemperance is general, and dram drinking especially prevalent. The disorders of which jewellers principally complain, are pains and soreness of the chest, disorders of the stomach and liver, and plethoric affections of the head. They enter the employ about 13 or 14 years of age, and are obliged to abandon it generally at 45-50. In an establishment of 37 men, two were under 20 years of age, twelve were between 20 and 30, thirteen between 30 and 40, and nine between 40 and 50 ; one only had passed the age of 50. An old jeweller is worthless to the art, and seldom indeed to be found. A master observes, that " the men drop off from work unperceived and disregarded. I am quite at a loss to know what becomes of them. When they leave off working, they go, and are seen no more. Some, perhaps, became applicants for charities; but so few have I known of the ages of 60 or 70, that leaving work, they seem to leave the world as well, a solitary one appearing at intervals to claim some trifling pension, or seek admission to an alms' house."

This is a melancholy, but, I fear, a correct representation of the end of artizans in other manufactures, as well as this, where health is either forgotten, or deliberately sacrificed to lucre, and where this lucre is devoted to intemperance–where the high wages moreover of a baneful employ, afford opportunities of absence from work for hours, or days–and where this absence or interval, instead of being devoted to the refreshment and renovation of the animal frame, harassed and injured by labour, is wickedly perverted to the induction of effects, more baneful than those of any art or occupation.



Charles Turner Thackrah died of tuberculosis in 1833, aged just 38. He never lived to see the advancement of occupational medicine and the improvement in working conditions that his exposure of the industry would produce.

Trev.
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Last edited by dognose on Tue Jun 02, 2009 1:32 pm, edited 1 time in total.
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Post by Granmaa »

Fascinating.
I'm glad that spoon making was relatively unharmful for the workers. I can collect with a clean conscience!

Miles
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Post by buckler »

Very valuable , not only for the medical details, but for what it
tells us of the various processes of manufacture and specialisations.
Again our thanks to Trev.
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Post by nigel le sueur »

Could not agree more about this article, very interesting

Nigel
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Re: Why Workers in the Silver Trade Died Early

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German Silver And Its Deadly Effect

A peculiarity of a worker in German silver spoons is the color of his hair. Years of labor in the trimming or buffing room of a spoon factory dyes the hair of the operative a pale green, which it takes years to change. The principal part of the composition of German silver is copper. The fine emery wheels used in trimming and shaping the spoon fills the air with minute particles of this noxious poison, that soon fills the lungs, colors the hair and eyebrows, and in time brings on a disease similar to consumption.

Source: Arthur's Home Magazine, Volume 53, T.S. Arthur & Sons, 1885.

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Re: Why Workers in the Silver Trade Died Early

Post by MCB »

Hello Trev

Which better explains all of those reported sightings of little green men.

Happy New Year
Mike
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Re: Why Workers in the Silver Trade Died Early

Post by dognose »

Hi Mike,

Yes, lots of little green men around this morning!

Happy New Year!

Regards Trev.
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Re: Why Workers in the Silver Trade Died Early

Post by buckler »

I regret to have to inform you that you have been reported to the European Commission for Non Human Rights under sections 1167( Chromatic Discrimination) and 1235 (Sexual Discrimination).

This behaviour is totally unacceptable in a modern society.

Your remarks about a Happy New Year are also under consideration by the EC as such references can cause offence to those who do not celebrate the start of the New Year on that date. The ethnic minorities, such as the Chinese, Indian, and Jewish communities must be mentioned by name in all such statements , and the rights of those still adhering to the Julian calendar also must be observed.

The British Goverment regards the 5th April as the start of the New Year but their views are not regarded as significant.

I wish all relevant entities a very happy 1st January to 31st December period, (Gregorian style) but accepting the rights of Julian observers to a similar but non contiguous period.
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Re: Why Workers in the Silver Trade Died Early

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SILVER-ABSORPTION IN PLATE-WORKERS

Observations made on eight hundred silver-workers in Berlin have shown that all of them had the characteristic patches of coloration. These patches are round or oval in shape, varying in size from a milletseed to a broad bean. As a rule, they are not raised; they are anaesthetic, and occur principally on the dorsum of the left hand. Only workers in silver are thus affected, and not those who manipulate gold or copper. The absorption of the metal seems to have no effect on the general health. Microscopical examination shows that the patches are caused by the deposit of metallic silver in the tissues, and they are soluble in nitric acid and potassium cyanide. It was noticed that the men affected were invariably those who had some ulceration or abrasion of the hands, through which the metal was absorbed. The nature and shape of the metallic deposit warrants the supposition that the metal enters in a soluble form, and is then precipitated. Three workmen who were being treated for syphilis with mercury developed a number of fresh stains in a comparatively short space of time.

Source: Boston Medical and Surgical Journal - Volume 117 - 1887 - Massachusetts Medical Society, New England Surgical Society

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Re: Why Workers in the Silver Trade Died Early

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During the ten years ending with 1906, the number of deaths of employes of jewelry establishments in Rhode Island was 557, from all causes. Of this number, 173, or 31.1 per cent, were from tuberculosis, and 51, or 9.2 per cent, from other respiratory causes. This means that 224 deaths out of the entire total were from diseases of the lungs and air passages. These figures are believed to have great significance as showing the excessive number of deaths from diseases of the breathing organs among employes in dust-producing establishments, as compared with the agriculturists, who live in a practically dustless atmosphere.

Source: The Metal Industry - April 1909

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Re: Why Workers in the Silver Trade Died Early

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EFFECTS ON ARTISANS EMPLOYED IN WORKING IN METALS

Workers in metals may be considered under five heads, as workers in arsenic, copper, lead, mercury, and, lastly, workers in gold and silver.

Arsenic.—The fumes of arsenic are extremely pernicious. It is an artificial production, and is prepared principally in Saxony from cobalt ores. Whilst the latter in the crude state are roasting for the purpose of obtaining zaffre, the vapours arising from the oxide are condensed in a long and large chamber, and to these potash is added. The mixture is then sublimed, and the white oxide is obtained, leaving potash with sulphur. This employment is a dangerous and, in a short time, fatal one ; and accordingly convicts, whose punishment would otherwise be death, are condemned to it. The men in the copper-smelting works of Wales and Cornwall are affected by the arsenical vapours arising from the crude ore, and they rely upon oil as an antidote, with which they are supplied by their employers. They are sometimes attacked with a cancerous disease similar to that which infests chinmey-sweepers. The arsenical fumes are believed to exempt them from fever. Some other artisans, as, for instance, paper-stainers and glass-workers, occasionally use arsenic and suffer headache and sickness from its employment.

Mercury.-—More than a century ago, Jussien gave an account of the workmen in the quicksilver mines of Almaden, in the province of La Mancha in Spain. "The free workmen at Almaden," he says, "by taking care on leaving the mine to change their whole dress, particularly their shoes, preserved their health and lived as long as other people ; but the poor slaves who could not afford a change of raiment, and took their meals in the mine, were subject to swellings of the parotids, apthous, sore-throat, salivation, pustular eruptions, and tremours".

Gold and Silver.—Workers in gold are subject to several pernicious vapours, the worst being that which arises in the process of dry colouring, from the fusion of saltpetre, alum, and common salt. It produces great distress in the head and nervous system. These evils are aggravated by a bad posture and the foul air of crowded work-rooms, so that an old jeweller is seldom met with. A communication made to Mr. Thackrah, by a master, is interesting and pathetic. We give it, though gloomy, as it is not by concealing the evils of trade that they are to be remedied :—"The men drop off from work unperceived and disregarded. I am quite at a loss to know what becomes of them. When they leave off working, they go, and are seen no more. Some, perhaps, become applicants for charities, but so few have I known of the ages of sixty or seventy, that, leaving work, they seem to leave the world as well—a solitary one appearing at intervals to claim some trifling pension, or seek; admission to an almshouse." Workers in silver have a tolerably healthy occupation ; they suffer but little from effluvia, with the exception of some who work in badly-constructed work-rooms.


Source: The Watchmaker, Jeweller and Silversmith - 5th July 1875

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Re: Why Workers in the Silver Trade Died Early

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THE BLUE MAN

By Arthur William Stillians


Among the exhibits in the side show of a circus or a fair the "Blue Man" is frequently seen, his body a pale bluish color, his face, neck, forearms and hands a fairly dark slate blue. He is a man who has put his silver into a bank from which no withdrawals are permitted. In spite of that, he has learned to cash it for many times the value in currency. He is using a few grains of silver distributed throughout his skin to furnish him a livelihood, a form of practical high finance which is peculiar in that it does no harm to others.

This condition is called argyria or argyrosis, derived from argentum, the Latin word for silver. It really is a form of chronic poisoning though the patient has no bad effect except the change in the color of his skin. The texture of the skin is not affected.

Long before written history began, silver was used as money and for jewelry. It was known almost as early as gold, for which the ancients used the same sign as that used to signify the sun, a circle. The left half of the circle, a semicircle open toward the right, was their shorthand for silver. By adding a curve to the center of this semicircle, a crescent is formed. Whether for this reason or because of the silvery light of the moon, silver was named luna by the alchemists. Our words lunacy and lunatic, from the same source, are souvenirs of the old belief that the light of the moon caused insanity. "In the spring the young man's fancy lightly turns to thoughts of love." For this mild form of insanity we still say, "He's moonstruck."

Silver nitrate, the soluble and therefore medically the most useful salt of silver, is still called "lunar caustic." It is no wonder that the alchemists reasoned that silver, the moon's element, ought to benefit insanity and other diseases of the nervous system for which the moon was held responsible, and for many years it was given for this purpose. Some of these nervous patients, after treatment for months or years, began to turn an ashy gray and then a bluish color.

The same change of color occurred after the use of silver internally as treatment for ulcer of the stomach and other diseases of the stomach and intestines, a more recent and much more rational use of the metal. In spite of its helpfulness in some of these conditions, its use has been much lessened recently because of better methods of treatment and the danger of a permanent discoloration of the skin.

Another inorganic salt of silver is the chloride, the white precipitate which is obtained by putting a drop of solution of table salt into a solution of silver nitrate. This white deposit is insoluble in water. On standing in the light it turns dark. The bromide of silver is much more sensitive to light; therefore it can be used to coat photographic negatives. Most of the salts of silver have this tendency to be darkened by light. As all housewives know, silver itself is darkened by the air, probably by the minute amounts of sulphur in the air, so that all silverware has to be polished at intervals.

The Blue Man's skin is full of minute particles of some organic form of silver, the exact form not yet determined. These granules have the same sensitiveness to light and turn dark under its influence. This explains why the skin of exposed parts of the body, the face, neck, hands and forearms, becomes so much darker than the rest of the skin. Under the microscope these granules are seen as very small bodies most plentiful in the portion just below the epidermis and near the skin glands. Of the light that penetrates the translucent epidermis they reflect only the blue rays, concealing the red rays reflected by the blood and thus robbing the skin of its rosy, healthful appearance. There is still much to be discovered about argyria for the cases vary greatly. One person may take many times more silver than the next before showing any skin change, or one may show darkening of the skin in one portion of the body, while another may present a widely different picture. The gums are supposed to show a blue line as the first sign of argyria, but many cases with a marked discoloration of the skin fail to show any blue line on the gums. Sometimes postmortem examination has shown that the internal organs have been heavily stained while the skin has remained normal.

The bones and muscles contain the chief deposits of silver; but the other organs have enough in them to make them very dark. A famous Blue Man, well known for many years in side show circles, was a former member of the British army. After his death the body was examined, and it was estimated that it contained a little over three ounces of silver.

Silver, like aluminum and iron, differs from other metals in being nonirritating to tissue, at least in the organic combination in which it exists in the body. These people carry their silver about with them without any sign of poisoning other than the skin color.

So great is the danger of discoloration of the skin that silver preparations are now given internally only for short periods or not at all. Other less dangerous methods of treatment are usually chosen. For local application, however, silver preparations are still widely used. The most valuable service that silver performs is the prevention of blindness in new-born babies. A drop or two of a weak solution of silver nitrate in each eye soon after birth acts to prevent a disease quite prevalent in women which, by infecting babies' eyes during birth, has caused thousands of cases of blindness.

Since the discovery of the colloidal and organic forms of silver, solutions of which are mild antiseptics, the use of silver as a local application to the eye, nose, throat, urethra, bladder and vagina has increased. The commoner preparations are named silvol, neosilvol, argyrol, protargol, collargol, argyn and solargentum, each containing the root "arg" for argentum or "sil" for silver. Many persons have no idea that argyrol and the other preparations whose names are based on the Latin root contain silver. Under medical supervision these drugs may be used without danger. When they become household remedies, however, there is danger of serious consequences. Each time the eye is treated, a little of the solution trickles through the tear duct into the nose and is unconsciously swallowed. The same thing happens when the nose, mouth or throat is treated. The long continued use of a hair dye containing silver has been known to cause discoloration of the skin, which is not uncommon among those whose work consists in grinding or polishing silver or who work in air containing silver dust.

Local argyria occurs when the silver preparation penetrates the epidermis of the skin or mucous membrane and finds permanent lodging in the connective tissue foundations. This is seen most frequently about the eye, in the lower lid or in the white of the eye.

The use of silver preparations as household remedies carries a serious risk. Many persons think that if a little is good, much is better. Some have a constant fear of infection and a nervous urge to treat themselves. If they get the habit of using silver preparations, some of them will eventually notice the skin losing its fresh rosy hue and becoming a ghastly gray. Even though the use of the drug is at once stopped the change may go on and the skin turn blue under the action of light. Whenever mother suspects that one of the family "is going to come down with a cold" she is apt to run for the argyrol bottle and put drops in the patient's nose or throat. Some mothers are alarmed at every sneeze and dose their suffering offspring constantly. Several cases of argyria occurring in children have been reported recently.

Since the general use of the silver preparations as a household remedy has become popular, cases of argyria have increased in number. Every one can do his part to prevent their occurrence by using silver preparations only under the direction of the physician, and by warning friends and acquaintances of the danger of their careless, misdirected use.

The wise doctor, when ill, goes to one of his colleagues to be treated and follows orders. There is a saying that he who tries to treat himself has a fool for a doctor and a fool for a patient. This is because it is hard to judge one's own condition, hard to get the right perspective of the case. How much more important it is for the layman to protect himself by having the advice of the physician in the use of a drug such as silver, which may have such evil consequences, consequences that come on without warning and remain for life.

Many methods of treatment have been devised for this condition, but most of them are ineffectual. A boy of 14, however, who had a chronic ulcerative inflammation of the large intestine and whose growth had been stunted by the long continued illness, was successfully treated by irrigation of the intestine with a weak silver nitrate solution. After six months of treatment he was so much better that he left the hospital but continued the irrigations. After eighteen months of treatment, the intestinal condition was cured, but the boy's skin had become very dark. Six years later he had increased in height and had become quite stout. As a consequence his skin became much lighter in color, simply because a certain amount of silver had been stretched over a much larger area of skin.

Three discoveries have recently been made which are of great aid in the treatment of argyria: 1. The bad effect of silver, the deposits that change the color of the skin, can be seen with the skin microscope about the nails before the general effect can be seen in the complexion, and the patient can thus be warned in time to prevent serious damage. 2. The amount of silver in the blood can be estimated by the spectroscope. 3. The silver deposit can be removed from the skin. When a photographic negative is too thick, due to overexposure, a reducing fluid is applied and some of the silver deposit is dissolved and washed away, making the negative thinner and the picture more distinct. One of these reducing fluids can be injected superficially into the skin, dissolving the silver granules which are washed away into the deeper tissues by the lymph stream. After the slight inflammation caused by the process clears up, a white spot is seen, practically as light as the normal skin. By frequent repetition of this process the skin color can be cleared. Even the lips and the whites of the eyes may be restored to normal color. Nevertheless, an ounce of prevention is worth a pound of cure. Nowhere does this apply more aptly than to argyria, for the prevention is easy and the cure long, tedious and painful.

The best service the doctor can give you is to keep you well. Let him protect you, in the use of the silver preparations, from the danger of becoming a blue person. A law to class all silver preparations as poisons would be useful. The druggist then would not dispense them except on the prescription of the doctor and would not refill the prescription without the doctor's order. Silver seldom causes death, but the possibility of causing a lasting deformity such as the blue skin is sufficient to justify its classification as a poison. It is up to each one of us, however, to refrain from using silver preparations carelessly.


Source: Hygeia - American Medical Association - March 1936

Trev.
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