Report of the Departmental Committee appointed to inquire and report whether the folowing diseases can properly be added to those enumerated in the third schedule of the Workmen's Compensation Act 1906 : namely (1) cowpox, (2) Dupruyten's Contraction, (3) clonic spasm of the eyelids, apart from nystagmus, (4) writer's cramp.

  • Great Britain. Home Office. Committee on Compensation for Industrial Diseases.
Date:
1913
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Licence: Public Domain Mark

Credit: Report of the Departmental Committee appointed to inquire and report whether the folowing diseases can properly be added to those enumerated in the third schedule of the Workmen's Compensation Act 1906 : namely (1) cowpox, (2) Dupruyten's Contraction, (3) clonic spasm of the eyelids, apart from nystagmus, (4) writer's cramp. Source: Wellcome Collection.

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    Dr. A. Rowley Moody; and two independent medical men specially qualified by their experience, z.e., Dr. W. G. Laws and Dr. F. Shufflebotham. After hearing the evidence of these seven gentlemen we circulated to certain ophthalmic specialists and others a schedule of questions designed to elicit definite expressions of opinion on those points on which there was still room for doubt. Their replies, which have been of the greatest assistance to us, are printed in full in Appendix XIL., and on a review of the evidence heard and the answers received, we are able to arrive at definite conclusions. We find that the word “ nystagmus” is no more than the name of a symptom, and cannot conveniently be employed to name a disease. It denotes only oscillation of the eyeballs. “ Miners’ nystagmus,” on the other hand, is a term well understood to name a disease or group of symptoms, practically confined to miners, of which oscillation of the eyeballs (2.e., “ nystagmus ’’) is the commonest, but not invariably present, objective sign. This disease has many symptoms, some subjective and some objective. We have no doubt that during its course, at some time or other, the symptom nystagmus appears in all cases. This is the conclusion we have come to on the evidence of those who have had the greatest experience, but we cannot deny that, among those we heard, much diversity of opinion was expressed as to whether it is present at all - times, or even susceptible of elicitation by repeated tests under conditions favourable to its perception. And, in some cases accompanying it, or in others even replacing it in the later stages, may be clonic spasm of the muscles of the eyelids. Conse- quently the symptom nystagmus, however easily found in a great majority of cases, ought not in all to be taken as a conclusive test either of the presence or of the absence of a disease of which, after all, it is but one symptom. We find further, that the suggestion that it has been taken as such a test is not altogether unfounded. We are satisfied that cases of miners’ nystagmus may have been wrongly diagnosed, and that certificates of disablement are likely to be refused, through too much insistence on this one test; and we are convinced that it is necessary to make it abundantly clear to all those concerned in the administration of the Act or in the diagnosis of cases, that the condition, the existence or non-existence of which to an incapaci- tating extent is to determine the question whether there can be a claim to compensation, is not the symptom nystagmus alone but the whole disease known as ‘‘Miners’ nystagmus.” We also find that it is not sufficient, and for various reasons would not be proper, merely to call attention also to the additional symptom clonic spasm; all the symptoms, whether subjective (e.g., movements of objects, headache, giddiness, night blindness, and dread of light) or objective (e.9., movements of the eyeballs, tremor of the eyelids, eyebrows, head, and even of the neck and shoulders) must be taken into account. ‘The question for decision is: ‘‘Do the “symptoms present in this individual, the objective symptoms and the subjective symptoms taken together, with or without the history of the case and the other available evidence, show that he has miners’ nystagmus to such an extent that he is wholly or partially incapacitated within the terms of the Act.”’ As regards the point raised in McGinn v. Udston, we find that the word “ nystagmus,” being only the name of a symptom, either names no disease at all and so gives no title to compensation, or (and this is the interpretation on which the court acted) includes nystagmus even when it is a symptom of forms of disease, (e.y., Friedreich’s ataxia, disseminated sclerosis, and tumour of the cerebellum) that are not industrial. In view of the evidence given to us and the facts disclosed by recent researches as to the causation of miners’ nystagmus by inadequate illumination at the coal face and elsewhere in the mine, we entertain the gravest doubt whether true miners’ nystagmus can ever occur in persons other than miners. The Committee of 1907, however, seem to have had such cases in mind (for though in the body of their report they referred to “ miners’ nystagmus,” in their recommendation they spoke only of “nystagmus a) We are, therefore, of opinion that any amendment of the existing schedule should be so framed as to preserve the existing claim to compensation for cases of miners’ nystagmus in persons other than miners, if such cases occur. Our conclusions are embodied in the following recommendations :— _ (1) To meet the point raised in McGinn v. Udston we recommend that the word ; Nystagutus ” added to the first column of the schedule by the Order of 22nd May 1907, should be replaced by the words ‘‘ Miners’ Nystagmus.” (2) To meet the case of workmen not engaged in mining possibly contracting the disease we recommend that the terms used should be “ miners’ nystagmus in miners or others.” - 46 66 +f