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U. S. D E P A R T M E N T OF L A BO R
B U R E AU

OF

LABO R

S T A T IS T IC S

ROYAL M EEK ER , Commissioner

BULLETIN OF TH E U N ITED STATES \
BU REA U O F L A B O R S T A T I S T I C S / *
INDUSTRIAL

ACCIDENTS

AND

—

HYGIENE

{No.267
SERIES

A N T H R A X
AS A N
O C C U P A T I O N A L
D I S E A S E




REVISION OF BU LLETIN 205

By JOHN B. AN D R EW S, Ph. D.

v

JU LY , 1920

W ASHINGTON
GOVERNM ENT PRINTING O FFICE
1920

CONTENTS.
Page.
Introductory summary....................................................................................... ..........
5 -7
Chapter I .— General description and history of anthrax................ - ..................... 9-13
Early studies of the disease.............................................. .......................... ......
9
D iscovery of the bacillu s.......................................................................................
10
Characteristics of bacillus and spore.................................................................. 11,12
Animals subject to anthrax, and countries where the disease is preva len t..
12
Conditions of soil and temperature favorable to the developm ent of anthrax.
13
Modes of in fection .....................................................................................................
.1 3
Chapter I I .— Medical aspects of human anthrax...................................................... 15-18
Symptoms.................................................................................................................... 15,16
Treatm ent................................................................................................................... 16-18
Chapter I I I .— Industries affected................................................................................. 19-23
Agriculture and other industries involving direct contact with anim als...
19
Leather industry....................................................................................................... 19, 20
Animal hair and bristle in du stry......................................................................... 20, 21
Wool industry............................................................................................................. 21, 22
Horn and bone industry..........................................................................................
22
Transportation.......................................................................................... .................
22
Nonoccupational anthrax...................................... ......... .......................................
23
Chapter IV .— Anthrax in the United States........................................................... 25-114
Early experience....................................................................................................... 25-32
Recent experience................................................................................................... 32-100
Experience of a leading morocco-leather center........................................ 32-35
Cases reported under New York occupational disease reporting la w .. . 35-37
Cases reported under New Jersey occupational disease reporting la w .. 37, 38
Cases reported under Pennsylvania infectious disease reporting la w .. 38, 39
Cases on record in a Philadelphia hospital................................................. 39-41
Cases on record in a Massachusetts hospital..............................................41-43
Cases reported b y tanners and leather manufacturers............................ 43-46
Fatal cases reported in registration area of theUnited States, 1910to 1917. 46-98
Distribution b y industry, place of death, e t c .................................. 47-58
Statistical summary..................................................................................58-65
Individual histories of fatal cases.......................................................... 66-98
Probable ratio of deaths to total number of cases.......................... . 9 8 - 1 0 0
Legislation.............................................................................................................. 100-114
Reporting........................................................................................................ 100-102
Prevention..........................................................................................................
102
Agriculture.............................. ............................................................ 102, 103
Trade and manufacture....................................................................... 104-108
Compensation................................................................................................. 109-114
Chapter V .— Anthrax in Europe............................................................................... 115-134
Private a ctiv ity ..................................................................................................... 115-118
Anthrax Investigation Board for Bradford and D istrict.................... 115,116
German employers’ mutual trade associations...................................... 116,117
Association of French Manufacturers for the Prevention of Industrial
A c cid e n ts .......................................................................................................
117
Milan Labor Clinic and other private activity in Ita ly ...................... 117,118
International organizations and congresses................................................
118
Governmental investigations................ ............................................................. 118,119
Systematic reporting and resultant d a t a .......................... ............................. 119-126
Great B rita in ................................................................................................. 119-122
G erm an y......................................................................... ............................... 122-124
F r a n ce .................................................................................................................
124
H o lla n d ........................................................................................................... 124,125
I t a ly ................................................................................................................. 125,126
R u s s ia ......................................................................... ’ ......................................
126

2




CONTENTS.

3

Chapter V .— Anthrax in Europe— Concluded.
Page.
Protective legislation........................................................................................... 126-131
Wool, hair, and bristles............................................................................... 127-130
Hides and skins............................................................................................. 130,131
Compensation for anthrax as an industrial in ju ry ........................................'132-134
Chapter V I.— Present status of the problem of disinfection.............................. 135-140
Chapter V II.— Recommendations for control and prevention of anthrax___ 141-148
Recommendations of the subcommittee of International Association for
Labor Legislation, 1914................................................................................... 141-143
Recommendations by Great Britain: Disinfection subcommittee of depart­
mental committee appointed to inquire as to precautions for preventing
danger of infection by anthrax in the manipulation of wool, goat hair,
and camel hair, 1918....................................................................................... 143-145
Recommendations b y C. H. W. P a g e ............................................................. 145,146
Recommendations by Prof. L /D e v o to and F. M assarelli..............................
147
Recommendations by United States: Public Health Service. Circular
letter of warning to State and local health authorities and others con­
148
cerned on anthrax and the sterilization of shaving brushes......................
A ppendix A .— Rules and regulations in the United S tates.............................. 149-166
United States: Treasury Department and Department of Agriculture Joint
Order No. 2. Regulations governing the sanitary handling and control
of hides, fleshings, hide cuttings, parings, and glue stock, sheepskins
and goatskins and parts thereof, hair, wool, and other animal b y ­
products, hay, straw, forage, or similar material offered for entry into
the United States, 1917................................................................................... 149-157
United States: Department of Agriculture, Bureau of Animal Industry.
Special order [B. A. I. Order 256] prescribing methods for the disinfec­
tion of hides, skins, fleshings, hide cuttings, parings, and glue stock,
and other animal by-products, hay, straw, forage, or similar material
offered for entry into the Unted States, and the containers of glue stock,
bones, hoofs, and horns so offered for entry, 1917.................................... 157-160
United States: Public Health Service. Amendment No. 6 to interstate
quarantine regulations, 1916, prohibiting the interstate transportation
of shaving brushes or lather brushes manufactured under insanitary
conditions, 1918.....................................................................................................
160
Massachusetts: Rules and regulations suggested for the prevention of an­
thrax, 1 9 1 6 ................................................V..................................................
161-164
New York: State industrial commission, division of industrial hygiene,
recommendations, 1916................................................................................... 164,165
New York City: Department of Health. Regulations governing the busi­
ness of preparing skins of an im als.............. - . ■
.................................................
166
Appendix B .— T ext of European regulations........................................................ 167-182
Great Britain: Regulations for handling dry and dry-salted hides and skins
imported from China cr from the West Coast of India, 1 9 0 1 ..................T 167
Great Britain: Sorting, willowing, washing, combing, and carding wool,
goat hair, and camel hair, and processes incidental thereto, 1905 ___ 168-171
Great Britain: Regulations for the processes involving the use of horse­
hair from China, Siberia, or Russia, in effect April 1, 1908 .................. 172-174
Great Britain: Anthrax prevention act, 1919............................................... 174,175
France: Decree relating to special hygienic measures for establishments
where the workers are exposed to anthrax infection, 19 1 3 .................... 175-177
Germany: Order concerning the equipm ent and operation of horsehair
spinning establishments, of shops where other animal hair and bristles
are manipulated, and of brush factories, 1902 .......... .............................. 177-180
Prussia: Order relating to the propagation of anthrax through animal skins,
1902 ................................................... ......................................‘ ....................... 180,181
Prussia: Regulations for the protection of workers against the dangers of
anthrax, 1910..................................................................................................... 181-182







BULLETIN OF THE

U. S. BUREAU OF LABOR STATISTICS.
WASHINGTON.

n o . 267.

j u l y , 1920.

ANTHRAX AS AN OCCUPATIONAL DISEASE.
B Y J O H N B. A N D R E W S , P H . D . 1

INTRODUCTORY SUMMARY.
A sudden and startling increase in the number o f illnesses and
deaths from anthrax in the United States drew public attention to
this occupational disease during the closing months o f 1915 and
the early part o f 1916. Most o f the increase took place in seaports
and tannery towns in the three States o f New Y ork, Massachusetts,
and Pennsylvania. New York, fo r instance, reported more deaths
from the malady in 1915 than had previously occurred in any State
in any single year since the Census Bureau began to give anthrax
a separate place in the m ortality statistics. In Massachusetts more
cases were reported during the first six months o f 1916 than in any
preceding whole year since the infectious disease reporting law in
that State went' into effect. The increase continued during 1917,, in
which year there were within one o f as many fatal cases officially
recorded by the United States Census Bureau as in the two heaviest
previous years combined.
The relative importance o f anthrax is shown by the fact that for
every five deaths from lead poisoning reported in the United States
registration area there is one death from anthrax, and that the total
number o f anthrax cases is about five times the number o f fatalities.
One Delaware physician was able to furnish, from his own prac­
tice, data on 48 cases treated within six years. D uring the same
period a single Philadelphia hospital treated 32 cases, 6 o f which
were fatal. In three years one State workmen’s compensation com­
mission passed upon 30 claims arising from this occupational disease.
Anthrax is prim arily a disease o f animals such as cattle and sheep,
but is transmitted to man in a number o f industrial pursuits. In ­
cluded among those who have died o f it in this country are hide and
1
O f information from scores of physicians, hospitals, and public officials in this
country and Europe during the past nine years, and of painstaking- analysis by tw o
faithful assistants, Anna Kalet and Solon De Leon, grateful acknowledgment is here
made.




5

6

BULLETIN OF TH E BUREAU OF LABOR STATISTICS.

skin handlers and other tannery employees, longshoremen, woolsorters, hair workers, brush makers, paper makers, farmers, ranch­
men, liverymen, and veterinarians. A m ong nonfatal cases reported
in several States and by a number o f hospitals the same groups o f
occupations are strongly represented. Infection has even taken place
in a carpenter, a steam fitter, and a stationary engineer, all o f whom
worked in tanneries, and in a customhouse official who weighed hides
and w ool on the docks. In some nonoccupational cases the disease
has been spread by insects and by pet animals which had been feed­
ing on diseased carcasses, and during the war period the necessary
shaving brush appears to have lost its harmlessness and to have
caused an alarming number o f cases, in military as well as in civil
life.
* The bacillus o f anthrax is one o f the largest and most easily recog­
nized o f disease-producing organisms, and its discovery about the
middle o f the last century marks the beginning o f modern bacteri­
ology. The bacillus, however, is not so much to be feared as a cause
o f disease as the spore, which is so resistant that it is used as a test
object for standardizing germicides. The spore can survive for as
long as 17 years without nutriment, is easily carried about, and when
provided with a favorable environment' rapidly germinates and sets
up a focus o f infection.
In man contagion commonly occurs through an abrasion o f the
skin, resulting in the so-called a malignant pustule ” or in “ m alig­
nant edema.” W oolsorter’s disease, or pulmonary anthrax, is a less
frequent but almost invariably fatal form o f the malady, caused by
inhaling dust or particles o f hair or w ool from diseased animals.
In rare cases the spores find entrance to the digestive system and
produce a gastrointestinal attack. The method o f treatment most
frequently used hitherto is excision o f the pustule where possible,
sometimes supplemented by intravenous injections o f antianthrax
serum. Now, however, some successful physicians are advocating
fo r external cases nothing more drastic than rest for the affected
part, stimulants, and local treatment with iodine and wet bichloride
o f mercury dressings. O ften in internal cases, physicians admit, the
disease fails to be diagnosed and its discovery is a “ surprise o f the
autopsy.”
In Europe both private and public forces have combined to carry
on an energetic campaign against industrial anthrax. The Anthrax
Investigation Board fo r B radford and District, in England, the
German and the French employers’ mutual trade associations, and
the famous Labor Clinic at Milan, Italy, have all made valuable
studies o f the disease and assisted in establishing preventive meas­
ures. The governments o f the leading countries long ago drafted and
secured the careful enforcement o f sanitary rules fo r the dangerous




AN TH RAX AS AN OCCUPATIONAL DISEASE.

7

industries, including w ool sorting, washing, combing, and carding,
hair sorting, brush making, and tanning. Further researches in
efficient and practicable methods o f disinfection are still under way.
In at least seven foreign countries anthrax is compensated as an
industrial accident.
In the United States, on the other hand, the problem has as yet
been given less consideration, although legislation fo r the report­
ing o f anthrax, both as an infectious and as an occupational disease,
is now fairly widespread and in some progressive States valuable
data are regularly being collected.
In the field o f prevention, especially, the United States lags behind.
Precautions taken by employers on their own initiative are crude
and few in number. A nti anthrax serum is scarce and not readily
available. No specific factory or workshop regulations fo r safe­
guarding w orking men and women from the disease have yet been
enacted by any State. The most effective American provisions on the
subject are contained in joint administrative orders o f the Federal
Departments o f the Treasury and Agriculture, which, beginning
January 1, 1917, prohibited the im portation o f hides, hoofs, wool,
hair, or other products from animals affected with anthrax and es­
tablished detailed requirements fo r the disinfection o f these products
i f imported from districts where anthrax is prevalent and fo r the
disinfection o f conveyances and o f certain premises. The period
during 1915 and 1916 when much laxer requirements were in force
corresponded roughly with a period o f extremely high anthrax fre­
quency, especially among longshoremen and tannery employees, and
the connection would seem to be more than accidental.
Tw o States authorize workmen’s compensation fo r all anthrax
contracted in the course o f employment, and in one State (Massa­
chusetts) many awards under this enlightened principle have already
been rendered. In a few other States compensation payments have
been made for anthrax contracted as the result o f a definite injury
received while at work. W ith the gradual spread o f workmen’s
compensation to include all personal injuries in the course o f em­
ployment, and ivith the probable development o f health insurance in
this country, an added incentive will be furnished for the prevention
o f this deadly disease.







CHAPTER

I.

GENERAL DESCRIPTION AND HISTORY OF AN TH R AX.
EARLY STUDIES OF THE DISEASE.

It was not until the latter half o f the eighteenth century that
valuable treatises on the subject o f anthrax or splenic fever (French,
“ ch arbon ” ; German, “ M ilzbrand ” ) began to appear .1 In 1769
Fournier, o f D ijon, France, published his historic work “ Charbon
M alin,” wherein a step was made toward recognizing the connection
between the various form s o f anthrax. A t about the same time the
ravages o f the disease became so serious and the need fo r a remedy
so urgent that the Academ y o f D ijon offered a prize for essays on
the subject. Some o f the works submitted were remarkable for the
thoroughness and precision with which they described the main symp­
toms o f human anthrax. These first scientific researches practically
mark the beginning o f the literature. Since then, at more or less
regular intervals, treatises on the disease, both in man and in ani­
mals, have continued to appear.
It was not, however, until a century later that the true nature o f
anthrax was revealed. In France in 1849 an investigation was under­
taken by a group o f medical men, in the course o f which it was
established that anthrax in man and anthrax in animals are identical.
Then began a search fo r the causes o f the disease. The theories ad­
vanced are characteristic o f the ante-Pasteur period when the mys­
teries o f bacteriology were still undisclosed and infectious diseases
were explained by spontaneous generation and by other subsequently
discarded hypotheses. F or anthrax, the influence o f soil, the sum­
mer’s heat, storms, insanitary conditions o f stalls and stables, and
errors in d ie t 2 were some o f the causes assigned.
irThe origin of anthrax is lost in antiquity.
Some authors trace it even to the time of
Moses and identify it with the sixth plague of Egypt. Allusions to it are believed to be
found in Homer. V irgil at the end of the Third Georgic gives a very vivid description
of an outbreak among domestic animals, the symptoms of which leave little doubt as to
its being anthrax.
Hippocrates, Galen, and Pliny the Elder all describe carbuncles,
which are diagnosed as anthrax by some modern authorities. . Periodic devastating
epidemics of the disease are mentioned by numerous writers, medieval and modern.
Thus Delafond, a French veterinary surgeon, held at one time that anthrax in sheep
2
was caused by “ an excess of blood circulating in the vessels,” due to “ too copious and
too substantial feeding.”
(D elafond : T ra its sur la maladie du sang des b§tes h laine,
1843. Quoted by J. CavaillS : Le Charbon Professionnel, 1911, p. 8 .) A t a still earlier
date Chabert, director and inspector general of the Royal Veterinarian College of France,
declared that “ anthrax tumors in general may, and should, be regarded as the effects of
an effort of nature to rid itself of the humor with which it is surcharged and the expul­
sion of which it is important to assist by all means that may achieve this result.”
(T raite du charbon ou anthrax dans les animaux, P aris, 1782, p. 33.)




10

BULLETIN OF THE BUBEAU OF LABOR STATISTICS.

DISCOVERY OF THE BACILLUS.

The anthrax bacillus was the first bacterium o f disease ever dis­
covered, and its isolation marks the birth o f the modern science o f
bacteriology. In 1850 a French village physician named Rayer, in
collaboration with Davaine, found in the blood o f a sheep which had
died o f anthrax what he called “ little threadlike, motionless bodies,
about twice the length o f a blood globule .” 1 Five years later, in
1855, a similar result was obtained by a German scientist, Pollender.
None o f these men at the time o f their discovery, however, was able
to explain the nature o f these bodies or their relation to the disease,
nor was anyone aware o f the greatness o f their contribution to human
knowledge.
Davaine, after a long series o f experiments, .came to the conclusion
that these bodies, constantly present in the blood and organs o f
animals dying o f anthrax, were absolutely distinct from the bacteria
o f putrefaction which were being studied by his contemporaries, and
that in them would undoubtedly be found the cause o f the disease.2
This forecast was brilliantly fulfilled in 1876 by Robert K och, who
later discovered the bacillus o f tuberculosis. K och conclusively
p ro v e d 3 the causal relation o f the bacterium to the disease, and fu r­
thermore demonstrated that the anthrax organism passed through
the two stages o f bacillus and spore which had previously been made
out by Pasteur in connection with a silkworm blight.
A t this point Pasteur took up the inquiry. The fact that certain
investigators,, even after K och’ s demonstration, maintained that the
disease often occurred without the presence o f bacteria led him to
subject the work o f his predecessors to rigorous verification. He
resorted to the method o f successive cultures. In a nutritive liquid
he placed a minute quantity o f fresh anthrax b lo o d ; a large number
o f bacteria appeared; a drop o f this liquid produced a new culture
which also showed germs, and so on to 20 cultures. Since the last
culture certainly contained not a particle o f the original anthrax
blood, and since it had the power to produce anthrax by inoculation,
Pasteur decided that it was not blood, but bacteria, that constituted
the cause o f anthrax. He also verified K och ’s observations o f the
reproduction o f the bacteria through fission and by spores. The
experiments o f these men, by presenting fo r the first time a complete
account o f the etiology o f anthrax, answered the most important
question in connection with this disease and made possible its further
scientific study.
1 Comptes rendus de la Societ-e de Biologie, 1850, p. 141. Quoted by J. C a v a ille : Le
C harbon ProfessLonn-el, 1911, p. 11.
2 Comptes rendus -do I’AcadSmie des Sciences, 1863, vol. 57, pp. 320, 351. Quoted % J „
■Cavaille, op. cit., p. 14.
3 Robert Koch : Die Aetiologie der M ilzbrandkrankheit begriindet -auf die Entwieklim gsgeschic&te des Bacillus Anthracis, 1876. Leipsig, 1910.
47 pp.




A N T H R A X AS A N OCCU PATIO N AL DISEASE.

11

C H A R A C T E R IS T IC S O F B A C IL L U S A N D SP O R E .

The bacillus o f anthrax (Bacillus anthracis) is a cylindrical or
rodlike body o f 3^ 0 to xsW inc-h i * length and about - 5100- inch in
1
2
diameter. Viewed with a microscope it is motionless, straight, and
transparent In the blood and other fluids o f a living animal, which
form the most favorable media, the bacillus multiplies very rapidly
by fission. The rodlike body becomes longer and divides into two
or more individuals similar to the parent. The multiplication o f the
bacillus can take place only in the presence o f substances entering
into the composition o f the bacillus itself, namely, water, nitrates,
carbohydrates, and minerals; a temperature o f 53.6° to 113° F. and
a supply o f oxygen are also necessary.
Another mode o f reproduction is by means o f spores. Spores can
be form ed in a medium similar to that favorable to the segmentation
o f the bacillus, except that free oxygen is necessary; fo r this reason
spores never form in the blood o f a living animal. Given the pres­
ence o f free oxygen, sporulation takes place when the medium be­
comes “ impaired, either because it was deprived by the bacillus o f
some o f its essential substances or because it became adulterated by
the accumulation o f products secreted by the microbe .” 1 Under
such conditions the bacillus instead o f dividing into segments
grows into a long thread inside o f which oval-shaped spores appear,
regularly spaced , 6 like peas in a pod.” The surrounding protoplasm
4
is dissolved or reabsorbed, and the spores are liberated. Thus the
spore seems to be form ed at the expense o f the bacillus its e lf; it is, so
to speak, the bacillus in a condensed form , and when placed in a fa ­
vorable medium it germinates and again becomes a bacillus. The
spore has been the subject o f numerous researches and its nature is
well known. It has been discovered that, unlike the bacillus, the spore
is marvelously resistant, a circumstance which makes the struggle
with the disease particularly difficult. The spore contains in itself the
elements necessary fo r life and can subsist for years in an environ­
ment entirely devoid o f nutritive materials, while the bacillus, left
to itself, very soon dies. Dr. Rebentisch ,2 o f Offenbach, Prussia,
states that after having lain dormant for 17 years the spore is still
capable o f germination.
In their susceptibility to heat, the microorganisms also differ con­
siderably. B lood o f anthrax-infected animals, containing bacilli
only, loses its virulence i f exposed fo r 15 minutes to a temperature
o f 131° F. The spore, however, is much more resistant. Tw o hours
o f boiling are required to kill all spores contained in a liquid culture;
raised in such a medium to 221° F. a few spores may resist for about
J. C a v a ille : Le Charbon Professionnel, Berger-Levrault, editeurs, Paris, 1911, p. 43.
2 Gewerbliche M ilzbrandvergiftungen, in Zentralblatt fur Gewerbehygiene, May, 1913,
p. 201.
1




12

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

15 minutes. In a dry medium the spores stand a temperature o f 248°
to 266° F. D rying, i f carried out rapidly, destroys the bacillus but
hardly affects the spore.
Equally resistant is the spore to antiseptics; numerous ex p ert
ments have shown that while the bacillus is easily destroyed, only
very high doses and prolonged exposure have any effect on the
spore. Nammack states that “ even catgut, prepared from the sub­
mucosa o f the intestines o f infected sheep, has been known to defy
all the elaborate preparations o f modern surgical technique, and
still convey anthrax infection to a wound .” 1 In fact, so hardy are
the spores that they have long been used as test objects fo r determin­
ing the efficacy o f germicides and o f other destructive agencies .2
This circumstance explains the difficulties in the way o f sterilization
o f materials, a question which will be taken up later in detail.
A N IM A L S S U B JE C T T O A N T H R A X , A N D C O U N T R IE S W H E R E T H E
D IS E A S E IS P R E V A L E N T .

Anthrax is prim arily a disease o f animals, from whom it is con­
tracted directly or indirectly by human beings. It is particularly
frequent among cattle and sheep, but may also be transmitted to
goats, horses, hogs, dogs, cats, and certain kinds o f game. Mice,
rabbits, and guinea pigs, in the laboratory experiments, are very
susceptible, while fow l are practically immune. This considerable
variety o f animals subject to anthrax aggravates the dangers o f the
disease.
Another serious factor is its world-wide distribution. H ardly a
country in the w orld is known to be entirely exempt, while a number
o f localities are reputed to be particularly affected. O f the European
countries, Russia and Italy are reported to be most severely affected
by both animal and human anthrax. W ell-enforced laws prescrib­
ing preventive vaccination o f animals and complete destruction o f
carcasses have succeeded in making it comparatively rare in E n g ­
land, Germany, France, and a few other European countries. In
the United States, anthrax is frequent among animals in the lower
Mississippi Valley, in the G u lf States, in the East (chiefly on the
banks o f the Delaware R iv e r), and in some o f the Western States.
On the South American Continent it is prevalent ill the less civ­
ilized districts o f Argentina, and in Patagonia and Uruguay. The
worst ravages o f the disease, however, are reported from Asiatic
countries, mainly Siberia, Persia, Asia Minor, Tibet, China, and
India, where phvBiographical conditions, deplorable ignorance, and
utter indifference conspire to make the materials exported from
those countries the most dangerous known to anthrax experts.
1 Charles E. Nammack : A Case o f Anthrax ; Excision ; Recovery, in New York Mcdical
Journal, 1897, vol. 66, p. 80.
2 E. O. Jordan : General B acteriology, 1912, p. 217.




A N T H R A X AS A N OCCU PATIO N AL DISEASE.

13

C O N D IT IO N S O F SO IL A N D T E M P E R A T U R E F A V O R A B L E TO T H E
D EVELOPM EN T OF A N TH R A X .

The frequency o f animal anthrax in certain countries is explained
not only by the absence o f precautionary measures, the most urgent
o f which are preventive vaccination, complete destruction o f car­
casses, and rational disposal o f waste products o f manufacture, but
also by conditions o f soil and temperature. Anthrax is mainly
observed on black, loose, humus soils, also on swampy land under
which impervious strata are found. Outbreaks are frequent in
places where spring inundations, which frequently wash over un­
buried carcasses, are follow ed by a dry hot summer. The moisture
contained in these kinds o f soil, and the organic matter always abun­
dant, furnish, i f combined with favorable temperature, an excellent
medium for the development o f bacilli and spores when, after the
inundation, the land dries, and the germs are either left in the ground
or disseminated by the wind.
M O D ES O F IN F E C T IO N .

Most cases o f animal anthrax are attributed to infection from
fodder, either through grazing on fields where carcasses o f victims
o f the disease have been left, or through eating hay cut from such
fields. W ater from streams receiving discharges from establish­
ments using infected material, artificial manure, and imported food ­
stuffs are also frequent causes.1 Transmission through blood-sucking
insects has been experimentally demonstrated ,2 but only rarely is the
disease due to the entrance o f germs into the air passages, and seldom
does it occur in animals through infection o f wounds.
Human beings contract the disease mainly through the handling
o f infected animal materials, either when these materials are ob­
tained by them directly from animals or else when they are being
transported or manipulated in industrial processes.
W orkers
handling infected goods sometimes transmit the disease to members
o f their families, either by means o f cloth in g 3 or through contact,
while they themselves may escape. Bites o f insects and even o f pet
animals which presumably had been feeding on diseased material have
been known to convey the infection, and in some cases the eating o f dis­
eased meat has been suspected. A certain number o f cases are also
due to the spores which have sometimes been found in shaving brushes.
1 In November, 1915, for instance, an anthrax outbreak occurred am ong the cattle o f
farm ers owning grass lands along the Johns River, N. H., who fed their live stock hay
cut from those lands. A ccording to the State departm ent o f agriculture, the trouble
seemed to arise from a tannery w hich emptied its waste into the river. A State veteri­
narian contracted the disease while making a post-mortem exam ination, but recovered.
See also pp. 28 and 30.
2 M. B. M itzmain : E xperim ental Transm ission o f Anthrax, reprint No. 162 from the
U. S. P ublic H ealth Reports.
3 The Journal o f the American M edical A ssociation for Apr. 26, 1913, for instance,
contained an account o f a woman in London who contracted anthrax presumably from
the clothes o f her husband, who was a laborer handling hides.







APPEARANCE OF ANTHRAX BACILLI AND SPORES.

(MG IF D A O T 800 D M T R ).
A N IE B U
IA E E S

(m g ified A O T 1200 D M T R ).
an
BU
IA E E S

COMMON APPEARANCE OF ANTHRAX ON THE SKIN.




FIG. 5.— LATER STAGE.

A DnC.Blt nB
.He s o a imr .

CHAPTER

IL

MEDICAL ASPECTS OF HUM AN A N TH R A X.
SY M PTO M S.

Human anthrax is caused by the entrance into the body o f anthrax
bacilli or spores, and by their rapid development and multiplication
in the favorable media there encountered. In a m ajority o f eases in­
oculation takes place through a scratch or cut in the skin; in such case
external anthrax results. This can be o f two kinds, ( 1 ) malignant
pustule, ( 2 ) malignant edema or erysipelatous anthrax. M ore rarely
the germs are inhaled and infeet the respiratory organs, or enter
with fo o d into the digestive tract; this is the origin o f internal
anthrax, with its two forms, ( 1 ) pulmonary and ( 2 ) gastrointestinal.
Many exaggerated ideas o f the deadliness o f the disease have been
current ,1 but it is now known that the vast m ajority o f cases end in
recovery. Hebentiseh 2 describes the main symptoms o f malignant
pustule as fo llo w s: The disease begins with a red pim ple o f the size o f
a pin’s head, form ed at the point o f inoculation. A s there is hardly
any pain, very little attention is paid by the patient to the disease
in this stage. The pim ple rapidly increases in size. It becomes sur­
rounded by a peculiar, resilient swelling, often o f considerable extent,
the so-called anthrax edema. In the center o f the pustule there is
a black spot around which the skin rises in blisters, this black spot
having given to the disease its French name o f charbon. The ap­
pearance o f the affected place is very characteristic and makes a last­
ing impression on anyone who sees it. On the third or fourth day
the lymphatic glands in the vicinity o f the pustule are usually swollen
and painful. In cases where the pustule is situated in the front part
o f the neck, the inflammation may attack the larynx and thus endan­
ger the patient’s respiration. Pustules may appear on several parts
o f the patient’ s body, but such cases are rare .3
Except fo r the local symptoms, slight cases are uneventful. Se­
rious attacks are marked by fever and by accelerated heart activity.
In critical cases the patient complains o f weakness and pain, and
1
An up-State N ew York paper in 1918 even went so f a r as to print the remarkable
statem ent: “ So m alignant is the disease tbat there is no known remedy for it, infection
being in variably fatal.”
5 Gewerbliche M ilzbranderkrankungen, in Zen tralblatt ftir Gewerbehygiene, M ay, 1913,
pp. 202, 203.
3
See colored plate ; also Plate 2, facin g p. 18. Figs. 1 and 2 are from Associazione

degli Industriali d ’Italia per prevenire gli infortun i del la v o r o : Istruzioni agli operai per
prevenire il CarboncMo.
Milano, 1909.
Figs. 3, 4, and 5 are from Great B ritain,
F actory Inspector's office, Form 410, M arch, 1908.




15

16

B U L L E T IN OF T H E BU EEA U OF LABOE STATISTICS.

delirium is not infrequent. I f the bacilli penetrate into the blood
stream and are not quickly overcome, the condition o f the patient
becomes worse and the disease takes a fatal turn. The complete
cycle o f the disease occupies on the average 9 or 10 days. Sometimes
death occurs much sooner.
In the other form o f external anthrax, malignant edema, the pus­
tule is absent. The edema or swelling usually covers an extensive
surface and is most frequently situated on the eyelid, neck, or fore­
arm. “ The local symptoms,” states Bell, “ are the extensive edema,
in slight cases, without redness, vesication, or eschar; in severe cases,
with redness, vesication, and a gangrenous appearance o f the skin.
There may be no pain, no distress, and no fever. Even in fatal cases
these are not very marked .” 1 This form o f the disease occurs much
less frequently than the pustule.
The internal varieties o f anthrax are comparatively rare. The
symptoms are not characteristic and can be easily mistaken for those
o f a number o f other infectious diseases; this makes diagnosis very
difficult and causes frequent error. A ccording to Nebolioubov, inter­
nal anthrax is often a “ surprise o f the autopsy ” ; it is also very posr
sible that many cases escape diagnosis.
Gastrointestinal anthrax, says Straus ,2 “ begins quite suddenly with
general weakness, pains, and shivering; this is follow ed by digestive
troubles, vomiting, colic, distention o f the stomach, diarrhea; the
whole body is affected; there is difficulty in breathing, weak pulse,
and cyanosis; death, most frequently in a state o f collapse, but excep­
tionally with tetanus-like convulsions, occurs in from two to five days
after the appearance o f the first symptoms.”
Pulmonary anthrax, more frequent than the intestinal form o f the
malady, is also known as woolsorter’s disease. A ccordin g to the
authority just cited, one o f its first symptoms is “ extreme weakness,
combined with headache and profuse perspiration; soon there appear
constrictive pains in the chest, difficult breathing, and cyanosis; aus­
cultation reveals congestion and edema in the lu n gs; sometimes there
is delirium ; the patient dies in a collapse; the disease usually lasts
from 4 to 8 days, but sometimes death comes more suddenly.” 3
TREATM ENT.

In the treatment o f anthrax the resistance o f the human body to
bacterial infection is a factor o f considerable importance. A number
o f physicians have tested the method o f “ expectant treatment,” based
only on the resistance o f the body, and found it successful in both
1 A nthrax— Its Eolation to the W ool Industry, John Henry Bell, in Dangerous Trades,
by Thomas Oliver, London, 1902r p. 637.
2 I. Straus : Le Charbon des Anim aux et de 1’Homme, 1887, p. 203.
3 Idem, p. 207.




A N T H R A X AS A N O CCU PATION AL DISEASE.

17

local and general affections. The prevailing tendency among med­
ical men, however, has been toward more energetic therapeutic
methods.
The kinds o f treatment now most frequently used are extirpation,
medicinal treatment, and serotherapy, either singly or in combina­
tion. Extirpation o f the lesion by excision, when it is in an operable
location, has been practiced since the eighteenth century. A vari­
ant o f this method is extirpation by cautery— either actual cautery
with a hot iron ,1 or cautery by means o f phenol or some other corro­
sive acid. B y some, however, including a number o f very success­
fu l practitioners, the method o f extirpation, especially by excision,
is at present held to be unreliable and dangerous. The excision, it
is said, does not always remove all the infected tissue, while the knife
in opening the vesicles may facilitate the entrance o f the bacteria
into the circulation and thus make conditions worse.
F or the medicinal treatment o f anthrax, great faith was at one
time placed in such supposed remedies as oak bark, lemon juice,
tobacco leaves, and roast onions, but these have now been discarded
in favor o f more scientific applications .2 F or instance, one experi­
enced American physician who in the last eight years has treated
more than 42 cases affecting the cutaneous and cellular tissues thus
describes his m ethod:
The part is thoroughly but gently washed w ith 1 : 2,000 chloride o f mercury
solution,3 dried well, then swabbed with 10 per cent tincture o f iodine and
some alkali applied. This is repeated daily for several days until the slough has
come away. It takes about tw o or three weeks for an ulcer to heal, which it does,
w ith very little scar as compared w ith the tissues involved. No systemic treat­
ment is necessary other than cleaning out the bowels, though some require
strychnine and alcoholic stimulants. I f the trachea becomes much involved,
nothing w ill prevent death by suffocation. It has-been my experience that
if the vesicles are kept unruptured it is better for the patient. The fatal
cases I have seen were those in which the vesicles had been ruptured.4

In some cases internal administration o f certain antiseptics, chiefly
iodine, is resorted to. These antiseptics can not be given in doses suf­
ficient to destroy the bacteria, but they are effective in im peding their
multiplication. Tonics and stimulants such as quinine, alcohol, wine,
} Successful treatm ent o f an anthrax case by actual cautery was reported from
Riverhead, N. Y., in the summer o f 1916. The patient was a prosperous farmer.
2 A. N. Bell, one o f the first Am erican w riters on anthrax, records a case in which
“ a physician was called, who, thinking the disease to be erysipelas, ordered the applica­
tion o f 24 leeches, to be follow ed by a poultice o f cow manure.”
(M alignant Pustule in
the United States, 1862, p. 16.)
*
3 The danger attending the use o f m ercuric chloride in this manner is illustrated by an
instance described by Balderston. A physician called in to a case found the patient
suffering from anthrax, and around the pustules a number o f punctures made by a hypo­
dermic needle. On being asked what he had injected, the physician w ho first had the
case in charge replied bichloride o f m ercury. “ He was not able to say exactly how much
had been given, but the man died o f bichloride poisoning.”
(Journal Am erican Leather
Chem ists’ A ssociation, July, 1916, p. 341.)
4 John Palm er, jr., in Journal Am erican M edical A ssociation, Nov. 6, 1915, p. 1670.

141633°— Bull. 267— 20------ 2




18

B U L L E T IN OF T H E BU E E A U OF LABOR STATISTICS.

or coffee, as well as the in halation o f oxygen, are also reported to be
bcneficiaL
Serotherapy, the third modern method, is as yet hardly beyond
the experimental stage, but it holds out important promise fo r the
future. It consists o f the injection, usually intravenously, o f fluids
from an immunized animal, containing germicides or having a neu­
tralizing effect on the germ ’s secretions. Several kinds o f serum
have been tested and found m ore or less effective. Perhaps the
greatest success is credited to the serum produced in 1895 by
Prof* Sclavo, o f Siena, Italy. A t first he experimented on ani­
mals, but in 1897 began to use his serum on human beings. A fter
six years he collected the records o f all cases in which his serum
had been applied, and found that, out o f 164 cases, only 10 had
resulted fatally. This m ortality rate o f 6.1 per cent is very low
as compared with that o f 24.1 per cent which is the general rate re­
ported by Italian statistics. The value o f this serum is recognized in
Italy to such an extent that in some cities workers in tanneries and
hair factories demand vaccination as soon as they notice a suspicious
mark on their skin .1 Recently the manufacture o f antianthrax serum
has been undertaken by a well-known American firm, but even the
American article is highly expensive, 80 to 100 cubic centimeters
being required fo r the initial dose, at a cost o f from $28 to $35.
It is still too early to form a definite judgm ent o f the value o f
serotherapy, but it is commended by a number o f anthrax authorities,
and its use is continually extending. It is, fo r 4instance, combined
with excision when possible in the routine treatment fo r all cases
o f anthrax admitted into certain prominent American hospitals and
into the B radford Infirm ary in England. In other anthrax centers
serum is given without practicing excision and with very successful
results. Another form o f serotherapy, the intravenous injection o f
normal ox serum heated fo r h alf an hour to 132f ° F., was originated
by R. Kraus, o f Buenos Aires. Penna, Cuenca, and Kraus report 140
cases thus treated, with only 1 death, which they compare with
Sclavo^s mortality o f 6.1 per cent. They conclude that u Sclavo’s
immune serum owes its efficacy in small part to specific immune
bodies and in the main to a nonspecific protein reaction which can
equally be obtained by the injection o f any other protein, and that
fo r these purposes, perhaps the least objectionable is heated normal
ox serum, which has the advantage over normal horse serum that it
does not produce sejum sickness.” 2
No matter what mode o f treatment is adopted, prom pt diagnosis
and rest fo r the affected part are stressed by leading authorities.




1 J. C availle : Le Cliarbon P rofessionnel, p. 112.
2 B ritish M edical Jou rn al, Nov. §0, 1918.




ANTHRAX INFECTION.
P H O T OG RAPH S OF P A T I E N T .

P L A T E 1.— BE FO R E IN F E C T IO N .

P L A T E 2.— M O S T A C U T E S TA G E O F IN F E C T IO N .




P L A T E

3.— S O R T I N G

U N W A S H E D

C h i e f l y i m p o r t e d f r o r r ' "'hina,

Russia, and

H O R S E H A I R .
South

CHAPTER

H I.

IN D U STR IE S A F F E C T E D .
AGRICULTURE AND OTHER INDUSTRIES INVOLVING DIRECT
CONTACT WITH ANIMALS.

A nthrax in man is, in the great m ajority o f cases, o f occupational
origin. In a number o f occupations anthrax is transmitted to the
workers directly by animals. Farm laborers, shepherds, butchers,
flayers, and veterinarians, fo r instance, contract the infection by
coming in immediate contact with the diseased animals or with their
carcasses.
More numerous are the groups o f persons who handle, fo r the pur­
pose o f manufacture, materials derived from infected animals. Such
materials are used in several very important industries, including the
wool industry, the manufacture o f leather and leather goods, wT
ork
on bristles and hair, and making artificial manure. Protection o f
the workers is particularly difficult in the leather industry, since
reliable and practicable means o f disinfection, such as exist for hair
and bristles, have not yet been conclusively worked out fo r hides
and skins.
LEATHER INDUSTRY.

No country in which the leather industry has developed to any de­
gree o f importance can depend entirely on its own supply o f hides
and skins. These products come in enormous quantities from less
highly developed countries, where manufacturing is hardly know^n
but where vast lands furnish favorable conditions fo r successful stock
raising. In these regions sanitation is usually unknown or neglected,
and clean materials are packed in the same bale with those which
have been infected. Materials imported from China, India, and
other Asiatic countries, and from some localities in A frica and South
America, are considered particularly dangerous.
The hides and skins are usually imported in a raw state. Before
being used in manufacture they must be subjected to the process
o f tanning. U pon their arrival at the tannery the skins are sorted
and then soaked. This soaking brings the “ dry ” hides to a moist
flexible state, which is necessary fo r a more complete absorption o f
the tannin from the subsequent tan liquors. A ll kinds o f skins—
“ dry,” “ wet salted,” and “ green ” (fre sh )— are cleansed, in the
“ soak,” from earth, blood, and dirt adhering to them and from, any




19

20

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

preservatives with which they may previously have been treated.
The “ soak ” may consist o f fresh water or o f water to which anti­
septics have been added, the contents o f the fluid, the time o f ex­
posure, and the details o f the process varying in different establish­
ments. This treatment, although it does not succeed in destroying
the spores, nevertheless diminishes considerably the risk o f anthrax
infection, because it washes away the blood, dirt, and other sub­
stances containing spores. The next step is to remove the hair. F or
this purpose the materials are placed in pits containing a saturated
solution o f slaked lime, where they remain for several days, accord­
ing to the class to which they belong. Even this prolonged lime bath,
which is a pow erful disinfectant fo r many purposes, is unable to
kill the anthrax spores. A s a result o f the action o f the lime the
hair is easily removed with a special knife. Then, any adhering
particles o f flesh are scraped o f f ; the skins are u delimed,” that is,
the remains o f the lime are washed o f f ; and this is follow ed by the
steps immediately preceding tanning and by tanning itself .1
The incidence o f anthrax varies in the different processes. Kebentisch ,2 as a result o f his own researches and those o f the German
Leather Industry A ccident Association, came to the conclusion that
only a small number o f cases occurred among workers in the depart­
ments where dry skins were manipulated, whereas the m ajority o f
victims were engaged in the processes o f soaking and washing.
Cavaille, from his study o f the tawT
ing works in the city o f St. Denis,
France, reached a similar conclusion .3 American and British ex­
perience, however, seems to contradict this, the m ajority o f tannery
cases in both these countries occurring in the early dry processes
such as unloading, storing, and sorting.
The various manufacturing processes, by additional cleaning o f the
skins, still further reduce the danger o f anthrax, but are not capable
o f removing it completely. There is always the possibility o f fin­
ished leather conveying the disease. In support o f this theory
Constant Ponder gives the follow in g evidence collected by him from
various authors : 4 (1) Shoemakers who have handled only leather
have contracted anthrax; ( 2 ) horses have contracted anthrax on the
flank where a new pair o f reins touched them; (3) it has been shown
that the spore sometimes survives, unharmed, the processes o f tanning.
ANIMAL HAIR AND BRISTLE INDUSTRY*

Another group o f industries where the danger o f anthrax is pres­
ent is that involving the manipulation o f animal hair and bristles.
1 See Plates 4 and 5.
2 Gewerbliche Milzbranderkrankungen, in Zentralblatt fur Gewerbehygiene, June, 1913,
p. 249.
3 J. Cavaille : Le Charbon Professionnel, p. 132.
4 Constant P on d er: A Report to the W orshipful Company of Leather Sellers on the
Incidence* of Anthrax among Those Engaged in the Hide; Skin, and Leather Industries,
with an Inquiry into Certain Measures Aim ing at Its Prevention. London, 1911, p. 17.




A N T H R A X AS A N O CCU PATIO N AL DISEASE.

21

The hair is obtained from horses, asses, mules, and ox en ; the bristles
from hogs and wild boars. The hair is used for making haircloth,
cords, gloves, and a number o f other articles, and fo r stuffing pillows,
mattresses, chairs, and saddles. The manufacturing countries do not
depend upon their own supply o f hair but im port large quantities
from China, Russia, South America, and other places, China supply­
ing more bristles than any other oriental country. O f all the vari­
eties o f hair, Russian horsehair is considered the most dangerous.
The hair reaches the factory in large compressed bales weighing
several hundred pounds. U pon the bales being opened the hair is
sorted according to color, length, and strength .1 Then it is either
shaken on a screen or combed. This process removes the dust from
the hair and separates the long hair from the short. The form er
method is used in weaving, the latter in brush making. T o make per­
manent the curl in hair used fo r stuffing pillows, mattresses, chairs,
and saddles, the hair is steamed fo r 15 to 20 minutes under a pressure
o f 1 to 2 atmospheres; other methods, such as exposure to dry heat
under ordinary pressure, are also used for the purpose. A fter dyeing,
i f this takes place, the hair is rinsed, dried, and packed. D yeing is a
very welcome process as far as prevention o f anthrax is concerned,
because the hair is left fo r several hours in a solution heated by the
passage o f steam. The heat is never sufficient to destroy the germs,
but the dirt is removed and probably the virulence o f the spores is
dim inished; however, the hair is not often dyed.
The early processes o f opening, sorting, and combing involve a
greater degree o f risk than the subsequent manipulation. This risk
is increased by the filth and dust, both o f which are notorious carriers
o f anthrax germs.
Bristles upon their arrival at the factory are also sorted and sepa­
rated from the dirt and from all bulky foreign matter; to remove
the finer particles o f filth the bristles are arranged in layers, sprayed,
with water, and left fo r a time. This produces decomposition o f
the still adhering foreign substances, which are then easily carried
away with steel combs. A fte r that the bristles are rinsed in cold
water, tied in packages, and dried. Frequently the better sorts o f
bristles arrive sorted and cleansed. A s in the case o f hair, the first
operations— unpacking, sorting, and combing— are more risky than
the others, and the prevalence o f anthrax among the workers en­
gaged in them has attracted considerable attention .2
WOOL INDUSTRY.

The danger o f anthrax is also present to a very marked degree
in the wool industry. W ool is obtained chiefly from goats, sheep,
1 See Plate 3, facing p. 19.
2 Two days after he injured his finger while at work in the factory of the New
Haven Brush Co., its president, Elm er W . Griswold, died Dec. 24, 1916, of anthrax
which the physicians believed was communicated to the wound from an infected bristle
of a hairbrush.




22

B U L L E T IN OF T H E BU EEA U OF LABOR STATISTICS.

and camels and is imported from some o f the oriental countries, such
as Asiatic Turkey, Arabia, Tibet, and Persia, also from Russia and
from some localities in South America and Australia. Like hair and
bristles, it frequently reaches the factory in a filthy state. U pon
opening, the wool is sorted according to color and quality, after
which it is freed from dust in the w illow ing machines, and blended
so as to obtain a uniform color in bulk. Then each sort is put several
times in succession through an alkaline bath at 180° F. This re­
moves any remaining dust and dirt and dissolves the blood clots,
which adhere to the wool with extreme tenacity and which, if from
an animal which has suffered from anthrax, contain abundant spores.
A fter rinsing and drying the wool is either combed or carded, ac­
cording to the use fo r which it is designed. The processes in the
wool industry, as in the industries previously described, vary in
different establishments. Particularly dangerous are the early opera­
tions, since the dirt and dust are laden with germs; indeed, pulmo­
nary anthrax owes its special title, “ woolsorter’s disease,” to its
appearance almost exclusively among workers in dusty wool proc­
esses. The liberation o f the spores by the alkaline bath accounts for
cases in the later processes o f carding and combing.
HORN AND BONE INDUSTRY.

A m ong other imported animal materials utilized in industry, horns
and bones are occasionally a source o f infection. They are used in
the manufacture o f combs, buttons, knife handles, corset bones, and
smoking pipes. D uring the breaking, cutting, and chipping, small
sharp fragments are projected which wound the worker and in this
way facilitate inoculation.
TRANSPORTATION.

The simple handling o f infected goods during their transportation
has also been shown to cause anthrax. Longshoremen, porters in
warehouses, and other transportation workers frequently contract
anthrax while loading or unloading infected materials. Sometimes
anthrax is transmitted to these workers not through immediate con­
tact with animal products, but indirectly. Cases are known o f
laborers having become infected from cargoes o f corn, wheat, and
barley. A pparently the grain had come in contact with infected
animal products or was stored in places where such merchandise was
previously kept.
Cases o f anthrax also appear among workers in glue factories,
rag-sorting works, felt factories, and establishments where fertilizers
and artificial animal food are being prepared. The danger o f in­
fection in these occupations is comparatively slight.




A N T H R A X AS AN O CCU PATIO N AL DISEASE.

23

NONOCCUPATIONAL ANTHRAX.

Anthrax statistics also include many cases o f persons between
whose occupation and the disease no connection can be traced, such
as children, housewives, persons without any occupation, schoolboys,
teachers, and professional men. In 1915 and 1916 several widely
scattered British cases o f the disease, including one death, were
definitely traced to shaving brushes, manufactured by one firm from
bristles o f Chinese origin ; a number o f the suspected brushes were
examined and found to contain anthrax spores which had survived
the process o f manufacture ,1 D uring the war the development o f a
number o f shaving-brush cases in America, among soldiers as well
as civilians, led to action by the Federal Government .2 This pos­
sibility o f unexpected attack and the fatal consequences which may
ensue, even despite energetic treatment, add greatly to the urgency
o f adequate measures fo r eradicating the menace.
1 Report of the County Medical Officer and School Medical Officer for the year 1915.
London County Council, August, 1916, quoted in Monthly Review of the U. S. Bureau
of Labor Statistics, November, 1916, pp. 1 0 8 -1 1 0 .
2 See pp. 148 and 160.










PL A T E 4.—S E L E C T IN G R A W S K I N S IN W A R E H O U S E OF K I D FA C T O R Y .




P L A T E

5.—

D R Y I N G

H A I R

A F T E R

R E M O V A L

F R O M

S K I N S

IN

A

K I D

F A C T O R Y .

CHAPTER

IV .

A N T H R A X IN THE UNITED STATES.
The record o f anthrax in the United States form s an absorbing
chapter in the annals o f the country’s tardy but gradual movement
toward the recognition and preventipn o f occupational <
disease.
Practically all the industries in which anthrax occurs are to be found
in this country, and cases have been known to medical men for the
better part o f a century. It is only in recent years, however, that
industrial and community responsibility fo r the disease has been
brought to the fore, and social activity fo r its control is still in the
early stages.
EARLY EXPERIENCE.

E arly American experience with anthrax is recorded only in
occasional papers by medical men who came in contact with inter­
esting cases, and the story thus preserved is necessarily very incom­
plete. Perhaps the first human cases so recorded in the United
States occurred in Philadelphia in 1834.1 A n epizootic o f “ mur­
rain ” broke out among the cattle near that city and finally spread
to the city itself, prevailing especially among cattle that fed on the
common. Several persons who had been engaged in skinning animals
that had died o f murrain were affected with the malignant pustule.
O f the three patients who were treated by the historian o f the out­
break, one stated that “ while he was skinning a cow dead o f murrain
a mosquito bit him on the back o f the hand. W ith the other hand,
which was covered with the blood o f the cow, he brushed away the
mosquito and rubbed the itching bite.” In all three cases the infec­
tion was on the hand, and all ended in recovery. A fourth case
occurred in the follow ing year (1835). A milkman skinned a cow
which had died o f murrain and carried the hide on his bare arm.
Several days later he noticed a pustule on his arm, from which he
eventually recovered. In all these cases the symptoms o f the m alig­
nant pustule in man were well characterized.
B y 1835, also, large numbers o f human cases had occurred in L ou­
isiana. E ight o f these were described by one physician ,2 who traced
1 C. W . Pennock : On the M alignant Pustule ; W ith Cases, in American Journal of Medi­
cal Science, Vol. X I X , November, 1836, pp. 1 3 -2 5 .
2 W illiam M. Carpenter: A Treatise on Malignant Pustule.
Thesis submitted to the
faculty of the Medical College of Louisiana, 1836 ; also Southern Medical Journal, Febru­
ary, 1839, pp. 2 5 7 -2 7 4 .




25

26

B U L L E T IN OF T H E BU E E A U OF LABOE STATISTICS.

the history o f malignant pustule in the region back to the* time o f
its settlement by the French and believed that the disease was first
noticed in America among deer feeding on the salt marshes near the
mouth o f the Mississippi River. Later it attacked the planters’
cattle, returning annually, and by the time he wrote it was prevalent
in nearly every part o f the State, but “ seems not to have been even
noticed in the medical annals o f Am erica.” During 1851 Louisiana
was visited by an anthrax epidemic which was compared 1 to that
described in the first book o f H om er’s Ilia d :
On mules and dogs the infection first began,
And last the vengeful arrow s fixed on man.

In several cases the disease was communicated to men by fly bites,
and once by dressing the lesion o f an infected mule. In Mississippi
outbreaks o f anthrax among animals occurred at intervals after 1836,
the losses o f cattle in 1865 and 1867 being particularly heavy.
In New England anthrax seems not to have attracted attention
until a later date than in the Southern States. In 1852 detailed
accounts o f six cases were published by a Salem (Mass.) physician ,2
who stated that fo r some time previously he had seen a case every
few years. H e enumerated several occupations in which the disease
occurred, but, in common with other physicians o f the period, he
indicated little knowledge o f its nature. Seven years later four
cases in New Y ork, three o f which terminated fatally, were described .8
A n important addition to the literature on anthrax was made in
1862, in the report on “ M alignant pustule in the U nited States,”
by A . N. Bell, a physician at the B rooklyn (N . Y .) City Hospital. In
this work Bell summarizes several previous American publications
on the subject and describes cases which occurred in his own prac­
tice. H e states that when a fatal case o f malignant pustule came
up fo r discussion before the K ings County Medical Society in July,
1859, members declared the disease had existed in Brooklyn fo r only
about four years. In December o f the same year three other cases
were reported to the society. Bell him self saw several other cases,
and heard o f 10 more in B rooklyn and o f several in New York.
H e also gave the names o f several physicians in the States o f Maine,
Massachusetts, Rhode Island, and New Y ork who had treated cases
o f anthrax. B ell’s experience with the disease convinced him o f
the value o f early diagnosis, the importance o f which has been
proved by later authorities. “ O f all the diseases that man is heir to,”
he states, “ there is none in which an early diagnosis is more im­
1 James H. Baldridge : M alignant Pustule, in New Orleans Medical Journal, September,
1851, pp. 2 0 0 -2 0 4 .
2 A. L. P eirson: M alignant Tubercle, in Boston Medical and Surgical Journal, Aug. 2 5 ,
1852, pp. 7 5 -7 8 .
3 Buck, in New York Journal of Medicine, 1859.




A N T H R A X AS A N O CCU PATIO N AL DISEASE.

27

portant than in malignant pustule. I t is indeed o f such moment
that the lapse o f a few hours or a day may entail the most deplorable
consequences.”
Struck by the repeated occurrence o f anthrax in the vicinity o f
W alpole, Mass., a Massachusetts physician 1 made careful inquiry
and found that in 1853 there first appeared in the town a “ most
singular disease, which was recognized by the attending physician
as charbon, or malignant vesicle, a malady known from remote an­
tiquity as prevailing among animals, but observed among mankind
only within a com paratively recent period.” The malady had been
reported from that locality at irregular intervals until during a
period o f 17 years 26 cases had come under observation. Twentyfour o f these cases occurred among hair workers, one victim was a
carpenter employed in a hair factory, and the remaining case was
that o f the wife o f one o f the victims.
The difficulties in the w ay o f diagnosing anthrax and the conse­
quent underestimate o f the real number o f cases were recognized at
a comparatively early period. “ The transmission o f this disease
to man,” said one practitioner in 1881, “ is far more frequent than
is generally supposed. * * * Under the names o f black erysipe­
las, carbuncle, diphtheria, etc., many eases occur that are easily
traceable to infection from animals. * * * In the last decade
I have been personally cognizant o f 13 eases, and fou r o f these have
occurred within the past tw o years in a town o f 10,000 inhabitants
and independently o f factories w orking up hair or hides, which
prove the most frequent sources o f infection . ” 2 The author con­
sidered the problem o f sufficient moment to demand sanitary legis­
lation and “ the most rigid measures for the suppression o f anthrax
outbreaks.”
The year 1892 is considered an important date in the history
o f anthrax in Delaware, a State where outbreaks o f the disease
am ong both human beings and animals have been particularly fre­
quent. In that year, according to Dr. Charles F. Dawson o f the
Delaware College A gricultural Experim ent Station, anthrax was
“ officially recognized as existing in Delaware.” This date seems
late as compared with 1834, the year o f the epidemic, previously
discussed, near Philadelphia, and 1836, the date o f the earliest re­
ported outbreak in Mississippi. However, Dr. Dawson admits that
“ while anthrax has been known to exist in the State only since
1892, it is highly probable that the first cases occurred much earlier
1
Arthur H . Nichols : On the Occurrence of Charbon, or M alignant Vesicle, in Massachu­
setts.
Massachusetts Board of Health, Annual Report, 1872.
2 James L a w : Glanders and Anthrax, in Cyclopedia of Practical Medicine (supp.), New
York, 1881, p. 202. .




28

B U L L E T IN OF T H E BUKEAU OF LABOR STA TIST IC S.

and that the disease is as old as the morocco industry .” 1 In the
outbreak o f 1892, when the officials were admittedly 4 inexperienced
6
in the management o f this disease,” several farmers contracted pus­
tules. Since that year outbreaks o f anthrax have been common
in Delaware. 6 Estimates made by veterinarians practicing in the
4
State show from 175 to 200 farm s in Delaware that are perma­
nently infected with anthrax. * * * The infected territory com­
prises about one-third o f the total area o f the State.”
Inform ation on the prevalence o f anthrax in the southern and
southwestern parts o f the country is com paratively limited. In 1894
an epidemic o f anthrax was reported near Como, La., where live stock
perished in large numbers and many people contracted the disease,
in some instances with fatal results. In the same year a California
medical m a n 2 stated that in Ventura County, Cal., alone, over 100
cases o f malignant pustule had occurred between the time o f its
first recognition and the date o f his article, and he suggested that
some cases had escaped diagnosis.
A remarkable case is recorded by D r. W . P. M cIntosh, o f the
United States Marine H ospital Service, as having occurred at Boston.
Eighteen months before fallin g ill the patient worked on a tramp
steamer which carried hides from a South American p ort; since
that time he had been employed on ordinary seagoing vessels.
4 The most probable exposure was at the time when the man was
4
employed on the vessel transporting hides from South America.
This, however, would presuppose that he had carried the infective
agent about with him as part o f his personal baggage fo r a period
o f 18 months. This is not inconsistent with the life history o f the
anthrax bacillus .” 3
The difficulties encountered by early physicians in the diagnosis o f
anthrax are well described by Nammack .4 One patient, a young
fru it handler in New Y ork City, felt a slight pricking or burning
sensation in the right eyebrow and upper eyelid; on the follow ing
day the lid became swollen. A surgeon was consulted and ordered a
lotion. Next m orning the patient went to an eye clinic, where he
was told that there was nothing w rong with his eye, but that he had
cellulitis o f the lid ; he was referred to the surgical class and again
given a lotion. A day later he called at Nammack’s office. The lid
then presented the appearance o f phlegmonous cellulitis, and the
doctor prescribed hot boric acid lotions and ordered him to return
next day for incision. The next m orning a messenger called to say
1 Bui. No. 90, Delaware College Agricultural Experiment Station, 1910. Anthrax, p. 17.
The manufacture of morocco leather from imported goatskins was established on a small
scale in W ilm ington, Del., as early as 1840.
2 C. L. Bard, in Southern California Practitioner, 1894, p. 121. « W . P. McIntosh, in Medicine, 1897, Vol. I l l , pp. 4 5 9 -4 6 1 .
4
Charles E. N a m m a c k : A Case of A n th ra x ; E xcision ; Recovery, in New York Medical
Journal, 1897, Vol. L X V I , pp. 7 8 -8 0 .




AN TH RAX AS AN OCCUPATIONAL DISEASE.

29

that the patient wasi delirious and that during the night a black
pim ple had developed on the eyelid. H e was immediately conveyed
to a hospital where the area surrounding the “ charbon ” was excised,
cauterized, swabbed out with pure carbolic acid, and then inoculated
with cultures o f the bacillus pyocyanicus. Portions o f the excised
tissue were sent to three laboratories and anthrax bacilli were re­
ported. “ Three observers had treated the case as one o f ordinary
phlegmonous cellulitis.” The probable mode o f infection in this
case w^as very unusual. In most o f the cases which Nammack had
previously seen the men had been handling hides. This patient was
repacking fruit sent to a commission house. Some o f the fruit came
from Spain in crates which were bound with strips o f rawhide.
A s he cut these strips one would occasionally fly up and hit him in
the face. It is probable, says the writer, that in this way the skin
was bruised and a way was opened for the entrance o f the microbe.
During the closing five years o f the last century, accounts o f anthrax
became very frequent. In 1896 the fatal case occurred o f a Philadel­
phia brush maker, who had been working on hogs’ bristles and
horsehair imported from Siberia and from the southern part o f
European Russia .1 The existence o f the disease was proved bacteriologically.
The next year five cases (fo u r fatal) occurred among the opera­
tives c f a Falls Creek, Pa., tannery. Hides imported from Asia and
infected with anthrax were found to be the source o f contagion .2 The
death o f a porter in a Boston leather warehouse was described in
1898.3 This man had been carrying hides on his shoulders. One
m orning while shaving he noticed a small “ pimple ” on his neck.
H e continued his work on that and on the follow ing day, but was
taken ill the day after and went to the hospital, where the pustule
was excised; he died a day later. Smears from the vesicles surround­
ing the pustule showed abundant bacilli.
Another fatal case o f a hide handler was reported the same year
from New Orleans .4 The patient had been employed in one o f the
largest hide stores in the city. W hen he was brought to the hospital
the two physicians who saw him concurred in diagnosing the disease
as anthrax. Antistreptococcic serum was injected, but the patient
died on the tenth day o f his illness. In his account o f the case Dr.
Dabney comments on the “ scant precautions which the dealers in
hides and wool in this country take fo r the protection o f their em­
ployees against this disease.” Dabney, like several other writers, is
1 M. B. M ille r : A Case of Anthrax, in Philadelphia Medical Journal, 1898, Vol. I,
pp. 3 4 0 -3 4 2 .
2 Medical News, January, 1897.
3 Abner Post, in Medical and Surgical Reports o f the Boston City Hospital, 1898,
pp. 226—
232.
4 T. S. D abney: A Case of Anthrax (Charbon), in New Orleans Medical and Surgical
Journal, 1 8 9 8 -9 9 , Vol. L I, pp. 3 7 7 -3 8 3 .




30

BULLETIN OF TH E BUBEAU OF LABOE STATISTICS.

convinced that many anthrax cases remain unrecognized. “ I can
not believe,” he says, “ that malignant pustule is as rare as our hos­
pital and board o f health reports w ould lead us to infer. A rather
careful look through the incomplete reports o f the Charity Hospital
from 1875 to 1897 fails to find a single case treated in that institu­
tion. * * * W e are forced to the conclusion that many cases o f
anthrax must have died in private practice as well as in our public
institutions, under the diagnosis o f erysipelas, cellulitis, carbuncle
(ordin ary), blood poisoning, etc.”
Anthrax, however, is by no means confined to the East and South.
In W isconsin, which is an important tanning center as well as an
agricultural and stock-raising State, an epizootic o f anthrax oc­
curred during July and August o f 1899 among the cattle in a certain
district. Not less than five persons contracted the disease through
skinning anim als; in all these cases the pustules were on the exposed
parts o f the body. Investigation by the health authorities led to
the conclusion that the cases among animals were produced by drink­
ing water from a river into which the tannery waste was discharged
and by grazing on meadows adjoining this river .1 In the same sum­
mer an outbreak o f anthrax occurred among tannery workers in
another part o f the State.
In a Philadelphia case 2 in 1900 the patient was a “ card stop p er”
in a large woolen mill. The illness began when he sustained a
punctured wound on his forearm while at work. E igh t days later
he was admitted to the h osp ital; the arm was dressed with a solu­
tion o f bichloride o f mercury, 1 to 10,000, and kept wet constantly.
Next day 1 dram o f 10 per cent carbolic acid was injected; on the
day after, 1 dram o f pure carbolic acid was used. A similar injection
was made daily during each o f the five follow in g days. A week
after admission the patient was up.
L ew a ld 3 describes a rapidly fatal case o f anthrax in a New Y ork
stevedore in 1902. The man had been unloading hides, and was
admitted to the erysipelas pavilion o f Bellevue H ospital on March 1.
Three days previously he had noticed a small pimple on his neck;
24 hours after that he was ill and unable to work. U pon his ad­
mission to the hospital he continued to grow worse and died on the
follow in g day. a A smear was made from the wound a few hours
before death, and the examination made at the laboratory confirmed
1 In November, 1916, an anthrax outbreak occurred among the cattle of farmers own­
ing grass lands along the Johns River, N. H ., who fed their live stock hay cut from
these lands. According to the State department of agriculture, the trouble seemed to
arise from a tannery which emptied its waste into the river.
A State veterinarian
contracted the disease while making a post-mortem examination, but recovered.
See
also pp. 13 and 88.
2 E. W . Fisher : A Case of Anthrax Successfully Treated by Local Injection of Pure
Carbolic Acid, in Therapeutic Gazette, Detroit, 1900, 3s., Vol. X V I , pp. 508—
510.
3 L. F. L e w a ld : A Case of Anthrax, in Proceedings of the New York Pathological
Society, February and March, 1902, pp. 24-26*




AN TH R AX AS A N OCCUPATIONAL DISEASE.

31

the diagnosis o f anthrax.” In the discussion on the ease the opinion
was expressed that anthrax is more frequent in New Y ork City
than wT commonly supposed. “ W ithin the last three or four
as
years, four or five cases have come into the dispensary o f the H u d ­
son Street Hospital. Singularly good results have been obtained
from early radical excision.”
In 1905 Drs. G. J. Schwartz and B. F. R ayer ,1 both o f Philadel­
phia, described to the Academy o f Surgery o f that city a case o f
anthrax in a farmer, who contracted the illness through skinning a
cow. In the pustule which form ed on the wrist anthrax bacilli were
found. The pustule was excised and the patient recovered after an
illness o f 35 days. In their report o f the case the authors make the
follow in g comment on the lack o f serum in this cou n try: “ From data
presented by Legge * * * and Sclavo, it would appear that the
time had come when we in this country should have a supply o f anti­
anthrax serum kept by health boards or research laboratories, where it
might be gotten in a few hours by those called upon to treat anthrax .5
9
When the patient came to the hospital requests for serum were sent
to tw o private laboratories, to the Marine H ospital Laboratory, and
to the Bureau o f Health o f New York, but no serum could be found .2
E arly cases o f human anthrax were frequent also in several other
States, including Texas. In that important stock-raising State out­
breaks among domestic animals occurred repeatedly, with conse­
quent infection o f human beings. A young woman, for instance, was
bitten in the face by an insect while anthrax was raging among the
cattle in the neighborhood .3 She died tw o days after admission to a
hospital. Another Texas victim was a dairyman who contracted the
internal form o f the disease from a cow and died on the eighteenth day .3
During the first decade o f the present century five States passed
laws fo r the reporting o f anthrax, among other infectious diseases.
These States are Massachusetts and Illinois (1907), Pennsylvania
and California (1909), and New Y ork (1910). In Massachusetts be­
tween August 1, 1907., and the end o f 1909 nine cases were reported,
seven o f which occurred in Lynn, an important center o f the leather
and shoe industry. The fatal cases recorded are somewhat more nu­
merous. Between 1865 and 1906, for example, a period o f 41 years,
128 deaths from anthrax were recorded in Massachusetts alone .4 The
United States registration area in 1900, the first year fo r which
deaths from anthrax were listed separately, included only 40.5 per
cent o f the country’s population, and in 1909 had increased only
enough to cover 56.1 per cent o f the population. Yet, in this re­
1 Transactions of Philadelphia Academy of Surgery, 1905, p. 76.
2 A few years later the Philadelphia Municipal Hospital and at least one progressive
m anufacturer began to keep Sclavo’s serum.
8 H. A . Barr : Report of Two Fatal Cases of Anthrax, in Texas Medical News, 1905-0^
Vol. X V , pp. 2 7 7 -2 8 1 .
4 U. S. Public Health Reports, Dec. 15, 193 6, p. 3399.




32

BULLETIN OF TH E BUEEAU OF LABOR STATISTICS.

stricted area 227 fatal cases o f anthrax were recorded fo r the 10-year
period. Deaths from this disease have steadily increased in number.
R E C E N T E X P E R IE N C E .
EXPERIENCE OF A LEADING M OROCCO-LEATHER CENTER.

A Delaware city, fo r two generations the center o f the moroccoleather industry in this country, furnished a favorable opportunity
fo r a community study o f occupational anthrax. Most o f the im ­
ported goatskins come dry in immense burlap-covered bales, weigh­
ing often more than 1,000 pounds each, from goat-eating countries,
including China, India, Arabia, North A frica , Brazil and other
parts o f South America, M exico, Spain, Macedonia, and Russia .1
These untanned skins form erly came by steamer to New Y ork, pre­
sumably under United States consular certificate to the effect that
the foreign agents o f this Government “ have not required disinfec­
tion under quarantine regulations because the shippers have declared
that anthrax, rinderpest, and foot-and-mouth disease do not prevail
in the districts in which the skins originate .” 2 The usual practice
has been to reship the skins, by smaller boats, from New Y ork to
Philadelphia and then again, sometimes by still smaller vessels,
to the Delaware city. Cargoes are now frequently shipped by train
from New Y ork, and recently the urgent demand has resulted in
some railroad shipments direct from the Pacific coast.
U pon arrival at the com pany’s warehouse the skins are unloaded,
sorted, and hauled as needed to the factory, where they are dumped
into tanks o f water to soak fo r 24 hours. W hen softened they are
drawn out and churned in large drums which separate from the
skins the most easily dislodged particles o f waste matter. Next
they are thrown into a second series o f vats and immersed for two
weeks in a solution o f lime and arsenic or other agents which loosen
the hair. These, the preliminary processes o f handling and pre­
paring the skins, menace the worker with the greatest danger o f
infection because the anthrax bacilli and spores have not yet been re­
duced in number or virulence by the later tanning processes. On
the contrary, each process preceding that o f lim ing is well adapted
to cause the anthrax germ' to flourish.
A t other tanneries the especially dangerous preliminary processes
are similar to those just described, differing principally with the
kind o f skins or hides to be manufactured into leather. The tanners
regard the danger as slight after the pelts have passed through the
lim ing process. That the danger, though in diminished degree, con­
tinues through later processes is indicated by occasional outbreaks o f
the infection among the beamers, fleshers, and splitters. The story
is told o f an engineer who came from another city to install a new
1 As a by-product one company
yearly to be made into blankets
infection to other establishments
2 Copied in April, 1916, from a




sells in this country about $200,000 worth of goat hair
or carpets according to grade. This spreads danger of
and to other communities.
consular certificate from Hankow, China.

AN TH RAX AS AN OCCUPATIONAL DISEASE.

33

mechanical device in a Delaware morocco factory and who contracted
anthrax when he bruised his hand while working among scraps o f
waste material on the floor beneath the old machine. But in this
Delaware city, as among tanneries elsewhere considered in this report,
most o f the cases o f anthrax have occurred among the handlers and
sorters o f imported dry skins in the receiving warehouses.
One physician in this morocco-leather center, who has in recent
years been most frequently called upon by the manufacturers to treat
victims o f the dread disease, furnished to the investigator the names
and descriptions o f 48 cases o f human anthrax treated in his prac­
tice during the past six years. A ll but half a dozen o f these were
from the receiving warehouse o f one morocco-leather factory. This
physician reports that only three o f his cases resulted fatally .1 The
infection in the m ajority o f cases was on the face or neck. In a few
cases it was on the shoulder, arm, hand, abdomen, or thigh. One
patient reinfected himself from the back o f his neck to his cheek.
Another suffered two attacks, first on the neck and then, nine months
later, on the arm. In no instance was the disease contracted from a
previously existing case in a human subject.
Other physicians interviewed gave meager accounts of their
anthrax experiences, speaking largely from memory, aided as to
names and dates by their cash accounts with leather manufacturers.
A ll referred to a local company physician, now several years de­
ceased, as having treated the greatest number of cases of anthrax.
According to his widow, who had acted as his drug clerk and was
familiar with his practice for 20 years, he often had as many as
four or five such cases at a time.
Local hospitals, on the plea that they are “ not equipped,” refuse
to receive anthrax patients, although a nurse in charge o f a private
institution cared fo r two or three such patients several years ago,
and one o f these, a serious case, is reported to have been sent to the
hospital by a physician under the mistaken impression that the
workman was suffering with erysipelas .2 One untrained woman told
the investigator that she had nursed four cases, including her own
son, in a room o f her boarding house, much to the consternation o f
the other lodgers, whose fear o f the disease made them reluctant to
pass through the sick room on their way to their own bedchambers .3
1 For methods of treatment followed by this experienced physician and by others in the
same city, see p. IT.
2 The refusal of hospitals to admit cases of anthrax seems not to be confined to Del­
aware.
R. L. Moore, of Elkland, Pa., s ta te s : “ In one case which proved fatal the
physician in charge was away, and a long automobile ride was necessary to reach the
nearest hospital. On being refused admission there, the patieht was taken on an all-night
trip to the nearest physician who was acquainted with the disease.
Although he was
in fair condition, it was too late to save the patient.”
(Journal American Leather
Chemists’ Association, July, 1916, p. 342.)
3 The ghastly appearance of some of the anthrax patients, with heads swollen until
their features practically disappear, is terrifying to their friends and leaves an impression

not quickly forgotten.
141633°— B u ll. 267— 20-------3




34

BULLETIN OF THE BUREAU OF LABOR STATISTICS

This untrained nurse, whose personal dread o f the disease led her to
don gloves and a mask, was o f the greatest assistance to the physician
in bringing back to health these patients, one o f whom suffered two
attacks within a year. “ I ran the additional risk o f losing my
boarders and lodgers,” said this woman, “ but the hospitals wouldn’t
take anthrax patients. W hat else could I do ? ”
Conversations with m orocco workers’ families brought out the fact
that fear o f this disease was common, and this fact probably in­
fluenced the State board o f health in issuing strict orders, which went
into effect A p ril 1, 1915, placing anthrax on the list o f infectious
diseases to be quarantined. The quarantine placards, printed by the
State and posted by the city health officials, read as fo llo w s:
This notice must be tacked on tlie front door.
ANTHRAX.
Until this notice is legally removed all persons
not occupants o f these premises are forbidden to
enter, and no person must leave this house or re­
move any article except by permission o f the health
authorities.

It is also required that every house in which a case o f anthrax
has occurred or exists shall be “ completely disinfected” upon the
recovery, death, or removal from such house o f the patient. Quar­
antine shall be continued fo r 14 days after disinfection.
A t the work places precautions against infection from materials
handled are not elaborate. A t only one warehouse was a warning
notice found posted. It was in two languages and read as fo llo w s :
N OTICE TO EM PLOYEES.
Use soap, water, flesh brush, and towels liber­
ally.
Rinse your hands in bucket o f disinfectant before
drying on towels.
Give special attention! to finger nails, always
keep them short and clean.
Do not scratch or pick any broken surface o f
the skin.
Report to office any form o f sickness, cuts, acci­
dents, bruises, pimples, or sores, for immediate at­
tention.
See that dressing rooms, washbasins, and toilets
are kept clean, and report to forem an any violation
o f above rules, for your own protection.
Caution all new employees.
W orking gloves may be obtained at office.




<
i

AN TH RAX AS A N OCCUPATIONAL DISEASE.

35

Universal was tlie testimony that the workers paid little or no
attention to written or verbal warnings except as the foreman or
superintendent with watchful eye detected an abrasion o f the skin
or a suspicious looking “ p im p le” and personally required the use
o f a disinfectant. It was commonly stated that in conform ity with
the requirements o f the local health officials a supply o f bichloride
o f mercury was constantly kept in readiness fo r disinfecting pur­
poses. A t three o f the warehouses visited, special inquiry was
made fo r the disinfectant, and in two cases bottles o f bichloride
o f mercury tablets were shown at the office, once, however, with the
bottle unopened and thickly covered with dust, while at the third
warehouse the foreman, with some embarrassment and after a per­
functory search, remarked that he believed the tablets had been
borrowed by the factory in the next block. In the same warehouse
there was one sink with a single faucet and one piece o f soap for
the ablutionary convenience o f the workmen, but it was admitted
that no warm water was available even in winter. “ The men all
wear gloves at their work,” said the foreman. Careful inspection
half an hour later, however, disclosed six out o f eight skin sorters
and truckers in a near-by corner working with hands unprotected.
“ W ell, they wear gloves in the winter,” was the foreman’s amend­
ment.
Yery general was the opinion among physicians and laymen that
hides and skins imported from districts where anthrax is prevalent
should be disinfected before they are landed in this country. One
official o f a tannery company, however, complained that the Federal
Government, during the preceding week, had required them to dis­
infect 700 hides, at a cost o f $ 120, because the hides had come
through without a consular certificate from the country o f ship­
ment to the effect that certain diseases, including anthrax, were not
prevalent at the time.
CASES REPORTED UNDER N E W YORK OCCUPATIONAL DISEASE REPORTING L A W .

The New Y ork occupational disease reporting la w 1 went into
effect on September 1, 1911, and between that date and March 31,
1916, 23 cases o f anthrax, 13 o f which were fatal ,2 were reported
to the State department o f labor. Nearly twice as many o f the total
number o f cases (15 out o f 23) and three times as many o f the
fatal cases (10 out o f 13) occurred in the last 12 months as during
the entire preceding period o f 43 months since the law became opera­
tive. This increase is probably due in part to more active compliance
o f physicians with the law, but as it coincides with large increases in
1 New York, Laws of 3 911, ch. 258.
2 For detailed accounts of 12 of these cases w hich. occurred prior to 191G, see pp.
6G to 84.




36

BULLETIN' OF THE BUREAU OF LABOR STATISTICS.

the number o f cases treated by hospitals in other States, as will
later be shown, there can be little donbt that it is, in the main,
in dicative,o f a real and startling growth in the prevalence o f the
disease. E ight o f the cases were reported from New Y ork City,
including B rook ly n ; four from Gloversville, the center o f the
American glove industry; four from Endicott, where there are large
tanneries and shoe shops; and one from each o f seven other cities
and towns. Twenty o f the patients were males, while three were
females. H a lf o f them were between the ages o f 41 and 60; the
youngest was a little girl o f 6 ; the oldest a retired lawyer o f 71.
The occupational group most largely represented was the hide,
skin, and leather workers, o f whom there were 10 (4 o f whom
died), including 6 employees o f hide tanneries, 3 workers on sheep­
skins, and 1 shoemaker. The shoemaker was employed in a large
factory and may have contracted the disease from an infected
hide in which the spores had survived the tanning processes .1 The
workers on sheepskins are described, respectively, as “ washer o f
sheepskins,” “ trim m ing sheepskins,” and “ limer and general helper,”
who had, however, just before infection, been “ helping store away
raw sheepskins.” A m ong the hide-tannery employees were one beam
hand, two who apparently worked in a freight gang conveying green
hides to one tannery only, two whose exact -occupation was not stated,
and— worthy o f special note— one steam fitter. A second occupa­
tional group was the transportation workers, represented by three
cases (tw o fata l). One was a dock laborer, one a baggage-master on
a dock, and one a driver. There were three farmers (tw o o f whom
d ie d ), and one from each o f the follow in g callin gs: “ Laborer in skin
m ill— drying sheep w ool,” spinner in rug mill, veterinarian, candy
packer, and la w yer; two were not engaged in industry. There were,
therefore, at least seven persons, and possibly nine, who became in­
fected through the transportation and early treatment o f hides and
skins before actual tanning was begun. The rug-m ill employee had
a pustule on the thumb “ follow in g scratch from piece o f tin on floor
o f spinning r o o m ” ; anthrax bacilli were fcund. The veterinarian
was infected while vaccinating cows, suffering from anthrax, on three
up-State farms. One farmer, who died, is believed to have caught the
disease from a sick cow which he slaughtered and dressed for beef .2
1 See p. 20.




2 See fatal case No. 78, p. 77.

37

A N TH RAX AS AN OCCUPATIONAL DISEASE.
Table 1.—C A S E S

O F A N T H R A X R E P O R T E D TO T H E N E W Y O R K S T A T E D E P A R T M E N T
O F L A B O R U N D E R T H E O C C U P A T I O N A L D IS E A S E R E P O R T I N G L A W , S E P T E M B E R ,
1911, T O M A R C H , 1916.
Septem ber
t o D ece m ­
b er, 1911.

O ccu p a tion .

H i d e , sk in ,
a n d leather
w o rk e rs........
T r a n sportat io n workers.
F a rm ers...........
V eterinarians
M iscella n eou s.
N o t in in d u s­
t r y ..................
T o t a l...

1912

1914

1913

J an u ary
to M arch,
1916.

1915

T o ta l.

Cases
Cases
Cases
Cases
Cases
Cases
Cases
re­ F a ta l
re­
re­ F a ta l
re­ F a ta l
re­ F a ta l
re­
F a ta l re­ F a ta l
F a ta l
p o rt­ cases. p o r t­ cases. p o r t­ cases. p o r t­ cases. p o rt­ cases. p o r t­ cases. p o rt­ cases.
ed.
ed.
ed.
ed.
ed.
ed.
ed.

1

1

1
1

1
1

1

1

1

4

2

2
2

1

2
1

2

1

3

2
2

1

1

2

2

9

1

1

4

3
3

2

12

10

3

2
2

4

3

1

2
4

1

2

23

13

None o f the cases is specified as having been internal. E ight o f
the lesions were on the face, fou r on the neck, three on the hand,
two on the arm, two on the chest, tw o on the hip, one on the leg, and
one not stated. In eight cases anthrax bacilli were actually found,
either in cultures from blood serum or by post-mortem examination
o f the organs, and six o f the cases in which bacilli were found resulted
fatally. On two patients antianthrax serum was used; one o f these
recovered .1
The result o f applications filed in certain o f these cases for indem­
nity under the New Y ork workmen’s compensation law is taken up on
pp. 112, 113.
CASES REPORTED UNDER N E W JERSEY OCCUPATIONAL DISEASE REPORTING L A W .

The law requiring the reporting o f occupational diseases in New
Jersey 2 w^as passed a year later than the New Y ork statute, the re­
sults o f which have just been described, and went into effect on July 4,
1912. The State board o f health, to whom reports are to be sent,
states that from that date to May 1, 1916, it received 13 certificates
regarding cases o f anthrax, all but one o f which arose in the city o f
1 A subsequent tabulation by the New York Department of Labor, bringing the data
down to Aug. 31, 1918, shows for the seven years since the occupational disease
reporting law went into effect a total of 60 reported cases, of which 15 were fatal. The
occupational distribution was as follows (figures in parentheses indicate fatalities) :
Tanneries, 24 (5) ; docks and warehouses handling skins, 13 (2 ) ; farm work, & (3) ;
brush making, 4 (2) ; boot and shoe manufacture, 1 ; driver, 1 (1) ; dry goods store, 1 ;
junk handler, 1 ; manufacture woplen rugs, 1 ; veterinary practice, 1 ; stable man, 1 (1 ) ;
miscellaneous, 4 (1 ) ; total, 60 ( 1 5 ).
T hat not all cases occurring in the State are
reported under this law, however, is shown by the fact that records of the factory
inspection bureau of the department contain for the much briefer period Jan. 1, 1916, to
June 5, 1919, no fewer than 74 cases, of which 19 were fatal. Among these, also, tannery
employees form by far the largest group.
2 New Jersey, Law s of 1922, ch. 351.




38

BULLETIN OF THE BUKEAU OF LABOR STATISTICS.

Camden, the seat o f extensive leather, kid, and morocco works .1 The
remaining patient was a feed merchant'in a small town, whose infec­
tion, his physician thinks, may have been “ due to carrying bags o f
feed on shoulder.”
Only one o f the 13 cases was fatal— that o f a receiver and checker
o f Russian horsehides. A ll the patients were men ranging from
21 to 55 years o f age; 7, or more than half o f the total number,
were between the ages o f 21 and 30. Four o f the lesions were on
the neck, two were on the face, and tw o were on the arm. “ Infected
part resembled a typical vaccination, except black,” says the physi­
cian o f one o f these. In another case the form o f the disease is
stated as external, but the location is not given; in the remaining
four cases the form is not stated, but since the patients recovered it
was probably external in these also. In only one case is the finding
o f anthrax bacilli reported; 100 c. c. o f antianthrax serum were used,
and recovery followed. Three other patients who recovered were
also treated with serum, one being given 10 c. c. and another “ about
eight injections,” while the third “ had 20 injections o f antianthrax
serum, 200 c. e.”
The occupations are known fo r nine o f the patients in addition to
the feed merchant, and all but one o f these were in contact with hides
and skins. Three were engaged at the same leather works, one as
a “ checker and receiver o f incom ing horsehides ” imported from
Russia, one as a “ stock assorter, examining hides and skins,” and the
third at “ assorting and handling hides.” O f three men employed
in a single kid shop two are designated only as kid or m orocco work­
ers, while one was a w ool washer. A patient from another kid plant
handled wet raw skins, while a stationary fireman in still another
factory o f this class contracted the disease after acting for the “ last
few months as sorter o f raw hides from Mexico and Central Am erica.”
T h e ninth man o f this group was a teamster, and had helped load
trucks with Russian sheepskin. Thus, at least six o f these men were
infected by raw skins during their transportation to and receiving
and sorting at the tanneries.
CASES REPORTED UNDER P E N N S Y L V A N IA INFECTIOUS DISEASE REPORTING L A W .

In Pennsylvania under the infectious disease reporting law 49
cases o f anthrax were reported in the three years between January 1,
1913, and January 1,1916. E ight o f the sufferers, including two hair
sorters and a tannery hand, were females. Nearly one-half o f the
cases, or 23, occurred in 1913, and 10 o f these were in the city o f
Philadelphia, one o f the centers o f the glazed-kid industry. A ll o f
the six cases reported in the first h alf o f 1914 also came from Phila­
delphia, thus making for that city a total o f 16 cases in 18 months.
1 During the subsequent period M ay, 1916-Ju ne, 1919, inclusive, 32 additional cases
were reported, making more than twice as many cases in a somewhat shorter period.
Again Camden was the city most heavily represented.




39

AN TH RAX AS AN OCCUPATIONAL DISEASE.

Here, as in the two States whose experience with anthrax under
occupational disease reporting laws has been described, the occu­
pational group most largely represented is hide and skin workers.
Five were given as tannery employees, two as leather workers, one as
a raw hide sorter, and one as a skin washer. Most o f the 12 classed
as laborers were also, it is reported, employed by tanneries. There
were eight hair workers, o f whom one was a haircloth examiner, tw o
were sorters, and one a brush m aker; a ninth case is given as “ a car
builder who might be included as a hair worker.” There were two
longshoremen, and one from each o f the follow ing callings: W ool
handler, “ raw stock ” inspector (without designation o f the kind of
stock), liveryman, teamster, merchant, carpenter, and roofer. Tw o
were infants 1 year and 10 months old, respectively, the father o f one
being a tanner and o f the other a coal miner. In eight cases the
occupation is not stated.
A t least 7 o f the 27 cases reported during the first 18 months
are known to have been fatal, and are discussed more in detail in the
section on anthrax fatalities reported in the United States registra­
tion area. A number o f the nonf atal cases were treated in a Philadel­
phia hospital and are considered, together with other cases at the
same hospital, in the next section.
CASES ON RECORD IN A PHILAD ELP H IA HOSPITAL.

One Philadelphia contagious-disease hospital reports a total o f 32
cases (6 fatal) from January 1, 1909, to A p ril 30, 1916. The great
m ajority o f the patients in these cases were men, only three— a hair
sorter, a hair twister, and one other hair worker— being w om en; all o f
the six deaths occurred among men. The patients were all residents
o f Philadelphia. Their prevailing age was markedly lower than that
o f the cases reported in New Y ork State, 12 o f them being between
the ages o f 31 and 40, and 10 between 21 and 30; the youngest was a
woman hair sorter aged 19, and the oldest a haircloth inspector o f 67.
The distribution o f these cases by years and by occupations was as
follow s :
T a b le

2 .—CASES OF A N T H R A X RECORDED B Y A P H ILAD EL P H IA HOSPITAL, JAN. 1,
1909, TO APR . 30, 1916.
1909 to 1911

Occupation.

H id e an d
skin workers
Wool and hair
workers........
Longshoremen
Miscellaneous.
O c c u pation
not reported.
Total. . .

1912

1913

1914

1915

Jan. 1
to ADr. 30,
1916

Total.

Cases
Cases
Cases
Cases
Cases
Cases
Cases
re­ Fatal re­ Fatal re­ Fatal re­ Fatal re­ Fatal re­ Fatal re­ Fatal
port­ cases. port­ cases. port­ cases. port­ cases. port­ cases. port­ cases. port­ cases.
ed.
ed.
ed.
ed.
ed.
ed.
ed.
2

3

3
1
1

1

4

1
5

1

1

10

3

2
1

3

1

1

3

2

17
2
2

3

3

4

3

32

1

1
8




1
7

1

6

1

4

1

1

6

40

BULLETIN OF THE BUREAU OF LABOR STATISTICS.

It w ill be noticed that the rate o f one case per month with
which 1916 began is nearly double the next highest rate, that fo r
1912, during which year seven cases were recorded. The increase in
fatal cases is still more striking, as many having occurred in the
first fou r months o f 1916 as in all the preceding seven years .1
The largest number o f patients were workers in wool or hair, due
no doubt to the local prominence o f this industry. Seventeen, three
o f whom died, were in this group, which covered a particularly wide
range o f processes. Thus there were four hair sorters ,2 one wool
sorter, one hair picker, one hair twister, three hair spinners, one wool
teamster, and four laborers in wool or hair plants (duties not differ­
entiated) ; even men comparatively remote from danger contracted
the infection, as witness a haircloth-loom fixer and a haircloth in­
spector. One o f the hair sorters wrorked in a horsehair factory;
the hair picker and at least one o f the hair spinners were employed
in a single curled-hair plant. The group next most largely repre­
sented is that o f the hide and skin workers, o f whom there were 10
(three o f whom died). One was a hide sorter, one a hide washer,
and one a sorter o f raw stock in a glazed-kid factory, while the
precise process carried on by seven tannery workers is not given.
Tw o sufferers from the disease were longshoremen, and in both cases
the hospital records state that fo r some days previous to the attack
the men had been unloading hides. O f the two classified in the table
as “ miscellaneous,” one was a shoddy worker who may easily have
contracted anthrax from the dirty rags he handled; the other was a
glue-factory hand who may have got it from hoofs or other parts
o f a diseased animal, although the hospital record further states that
he “ occasionally handled leather.” In only one case among this
valuable set o f records is the occupation not stated. Throughout, the
connection between occupation and contagion is much closer than
in the New Y ork series.
In all o f the cases recorded by this hospital the disease took the
external form . The pustule occurred in 19 cases on the face and in 10
cases the neck, the six deaths being distributed equally between these
twT groups. Three lesions were on the arm, and one on the hand;
o
one case is noted— that o f a girl hair sorter— in which lesions ap­
peared both “ on jaw and wrist.”
Due to the care with which these records were kept, valuable data
regarding the duration o f anthrax attacks are available. The six
cases with the shortest duration— ranging from three to eight days
1 Subsequent information from this hospital for the period Jan. 1, 1 9 1 6 -J u ly 15, 1919,
shows 19 additional cases treated, of which 7 resulted fatally. On Apr. 11, 1916, Chief
Medical Inspector Cairns, of Philadelphia, stated that from 10 to 12 cases of anthrax
developed in Philadelphia annually.
2 One of these, who contracted the disease in 1916, filed a claim for compensation,
which was denied on the ground that infection had not taken place through a
wound or
other unusual incident.”




(See p. 113.)

AN TH RAX AS AN OCCUPATIONAL DISEASE.

41

after appearance o f the first symptoms— were all fatal, and these
were the only cases which so resulted. The next shortest case termi­
nated in recovery and discharge from the hospital on the seventeenth
day o f the disease. The most protracted illness lasted for 51 days.
The duration o f illness and number o f cases o f death were as fo llo w s:
{P a b le 3 — DU RATION

OF ILLNESS, AN D D EATH S AMONG 32 CASES OF A N T H R A X IN
A PH ILAD ELPH IA HOSPITAL.

Duration of illness.
Under 1 week................................................
1 week and under 2 weeks............................
2 and under 3 weeks....................................
3 and under 4 weeks....................................
4 and under 5 weeks......................................
5 and under 6 weeks......................................
6 and under 7 weeks.................................
Over 7 weeks.................................................
Total....................................................

Cases.

Deaths.

5
1
5
8
4

5
1

5

3
1

32

6

In the overwhelming m ajority o f cases, 22 out o f 32, treatment
was by excision and serum; o f these, three died. In five cases ex­
cision alone was performed, and two deaths resulted. One man was
brought to the hospital moribund and neither method was applied;
he died eight hours later. In four cases the mode o f treatment was
not reported .1
CASES ON RECORD IN A MASSACHUSETTS HOSPITAL.

The records o f one Massachusetts hospital show 35 cases o f an­
thrax between June 27, 1881, and A pril 26, 1916. O f these 6 were
fatal, 26 were nonfatal, and 3 patients were still in the wards at
the time o f the investigation. The recent increase in prevalence
revealed by the New Y ork and Pennsylvania reporting laws is
here paralleled. The number admitted during the first three months
and 26 days o f 1916 (9 out o f the 35) is thrice that admitted
in 1915, and equals the number treated during the whole period
1881-1904, inclusive .2 The largest number o f cases from single cities
came from Boston (5 ), W oburn (5 ), and Winchester (4) ; five other
towns in the vicinity o f Boston sent 2 cases each, and 11 towns 1
case each. Only 1 o f the 35 patients Avas a woman. Fifteen were
1 The numerous instances of death from anthrax in Philadelphia was one of the rea­
sons given for the establishment during the summer of 1916 of the clinic for occupational
diseases at the University of Pennsylvania Hospital in that city.
2 The total number of cases reported in the State during the first half of 1916 was
25.
“ This was the severest outbreak of this disease ever recorded in Massachusetts.”
Twenty of the cases occurred in three tanneries and were traced to a common source,
a single cargo of dried “ C h in a ” hides from infected territory.
(United States Public
Health Reports, Dec. 15, 1916, p. 3401.)
Subsequent reports from this same hospital,
covering the period June 2, 1 916-J u ly 15, 1919, show 15 additional cases treated, of
which 2 were fatal.




42

BULLETIN OF TH E BUREAU OF LABOR STATISTICS.

between the ages o f 21 and 30, 15 were between 31 and 50, 2 were
between 61 and TO, and the remaining 3 were between 11 and 20
years o f age.
H ide and skin workers made up nearly half o f the total number
o f patients— 16 out o f 35. Thirteen o f these were tannery workers,
one was a m orocco worker, one a leather worker, and one a 6 laborer
4
handling raw hides.” The “ leather worker ” was in charge o f men
cutting fresh hides. O f the tannery employees two were “ beamers,”
who scraped hides and put them through rollers; two split hides; two
others took hides from the soaking pits; three o f these six were re­
ported as handling wet hides. One man handled hides as a teamster
fo r a tannery, one was a flesher, one is designated merely as “ la­
b o r e r ” in a tannery; one was engaged on sheep and goat skins; in
the three remaining cases no inform ation was given beyond the
w ord “ tanner.”
Transportation workers were represented by nine cases, two fatal.
Four were dock laborers; two were freight handlers, on e-of whom
handled raw hides and w o o l; tw o were weighers o f skins and hides;
and one was a teamster. F ive patients wT
ere employed in the w ool
and hair industry. T w o were employed in a w ool factory, one o f
them as a carder; in the other case the infection was so serious that
it necessitated amputation o f the arm at the shoulder. One was
an upholsterer’s helper and handled w ool used for stuffing. Tw o
days before com ing to the hospital he cut his neck while shaving;
infection developed on neck and chest, and fou r days later “ patient
looked as i f he weighed over 200 pounds.” One was a teamster cart­
ing wool, and one was em ployed in a hair factory.
In addition to these workers, whose employment bears a welldefined relation to the disease, two patients were designated merely
as laborers. One o f these, however, was employed in a soap factory.
Three wreeks before he was admitted, to the hospital, it is reported,
a box o f skins was sent by mistake to the factory, where it was
opened and a skin was kicked about by a fellow workman, striking
the patient in the back o f the neck. R ag workers, factory girls, and
machinists were also represented by one case each.




43

AN TH RAX AS AN OCCUPATIONAL DISEASE.

T a b l e 4 .— CASES OF A N T H R A X ADM ITTED TO A MASSACHUSETTS HO SPITAL, JUNE 27,

1881, TO APR. 26, 1916, B Y OCCUPATIONS.

June 27,1881,
to Dec. 31,
1911
Occupation.

Hide and skin
workers........
Wool and hair
workers____
Trans p o r t a tion workers
Miscellaneous.
T o ta l.. .

1912

1913

1914

Jan.1 to
Apr. 20,
1916

1915

Total.

Cases
Cases
Cases
Cases
Cases
Cases
Cases
re­ Fatal re­ Fatal re­ Fatal re­ Fatal re­ Fatal re­ Fatal re­ Fatal
port­ cases. port­ cases. port­ cases. port­ cases. port­ cases. port­ cases. port­ cases.
ed.
ed.
ed.
ed.
ed.
ed.
ed.

5

2

3

1

4
5

1
2

17

4

2

1

7

16

2

1

1

5
1

2
3

1

1

3

1

2
1

1

9
5

2
2

9

1

35

6

The duration o f illness was short in the 6 fatal cases. One such
case lasted 3 days and another 5 d a ys; 3 patients died after an illness
o f 7 days each and 1 after 8 days. The shortest o f the nonfatal cases
lasted 10 days; in another the patient w^as ill 13 days; 6 lasted be­
tween 14 and 21 d a y s; in 9 cases the duration was 21 days but under
28; 8 persons were ill 28 days or more. O f those remaining, 1 was
an out-patient and 3 were still in the hospital wards at the time
o f investigation.
The situation o f the pustule is given in all but one fatal case,
which, according to the symptoms, was probably internal. In a
m ajority o f cases (20 out o f 35) the lesion was on the neck, 9 lesions
were on the face, and 5 were on the arm or hand. In 18 o f the total
number o f cases and in 5 o f the 6 which ended fatally, examination
disclosed anthrax bacilli . 1
CASES REPORTED BY TANN ERS AND LEATH ER M ANUFACTURERS.

In the course o f preparing this report the Bureau of Labor Sta­
tistics sent about 1,400 circular letters in regard to anthrax to tanners
and leather manufacturers. T o these, 592 replies were received.
Nineteen establishments reported 70 cases o f anthrax within the
last two or three years, 6 o f these cases being fatal .2
W hile these cases probably duplicate to some extent the cases else­
where discussed in the report, it is convenient to present them to­
gether.
1 For additional records of M assachusetts cases, see pp. 26, 27, 28, and 1 0 9 -1 1 1 .
2 A t the same time, 1,600 similar inquiries were sent to wool dealers and wool manufac­
turers, but elicited a report of only one case, that of a Boston laborer trucking wool, who
recovered under hospital treatment.




44

BULLETIN OF TH E BUEEAU OF LABOE STATISTICS.

T able

5.

-A N T H R A X

CASES R EPO R TED B Y N IN E T E E N TAN N IN G AND
M ANUFAC TU RING ESTABLISH M ENTS.
Occupation
of victim.

Treatment.

No. 1.

Sweater in
tannery.

At home—local phy­
sician.

Massachusetts:
North Woburn. No. 2..

Tanner.........

At Massachusetts Gen­
eral Hospital.
At home........................
At Massachusetts Gen­
eral Hospital.
Local physician...........

Location.

Maine:
Island Falls. .

Norwood.

No. 3..

W oburn..

No. 4..
No. 5..

No. 6.
Michigan:
Cheboygan.

Flesher.........
Beam-house
hand.
No informa­
tion.
Beamster___

LE A T H E R

Precautions now taken.

Full recov­
ery.

None.

........do........... Have discontinued use
of China hides.
. . . . .d o ........
........do...........
........d o.........

No information.

At Massachusetts Gen­ Recovery ex­ Daily examination of
eral Hospital.
pected.
all employees.
2 cases; oc­ ........do............................. Full recov­ Use solution recom­
mended by State in­
ery.
cupations
spectors ; stoppedtannot given.
1 case............ At home........................ ........d o...........
n in g dry China hides.
Carbolacitin used as
5 cases; oc­ Some by local phywash by men, and in
sicians, and others
cupations
soak pits.
not given.
at hospitals.

No. 7.

3 -year - old
daughter
o beamhouse em­
ployee.
Beamster...

Munising.

No. 8 ..

Beamster. . .

New Hampshire:
Whitelield...

N o .9..

.d o ...
.d o .. .
.d o .. .

New Jersey:
Camden.

Antianthrax serum; ........d o.........
tincture iodine in­
jected hypodermic­
ally around area of
infection.
Antianthrax
serum Full recov­
and early excision of
ery
(32
primary lesion.
days).
Sores washed with car­ Full recov­
bolic acid and io­
ery.
dine; face and neck
washed with iodine,
vitriol j and cam­
phor oil; gauze pack
saturated with boric
acid and epsom salts
(hot water) applied
to face for 5 days;
ice-cold baths when
fever over 103°.

No. 10. ........do...........

.do___
.d o____
.d o ... .

Carbolic-acid wash kept
on hand for use on
cuts, etc.

Disinfect hides in solu­
tion of bichloride of
mercury and com­
mon salt.

At home, by company ........do........... Antianthrax
serum;
physician.
solution of bichloride
of mercury on hand
for use by employees.
No. 11. Raw - stock Diagnosed as anthrax Fatal.
Breaks in skin of em­
d e p a r t­
too late to be treated
ployees in raw-stock
ment; dry
for same.
department cauter­
ized by factory doc­
horsehides
tor.
____do........... Antianthrax serum; in­ Full reeovjecting 20 c. c. every
ery(3 weeks
4 to 6 hours; high fre­
4 days).
quency electricity
and fulguration used
over primary lesion;
lachisis used inter­
nally.
.do.

Novark.

Hospital treatment___
------do.............................
------do.............................

China hides put into
corrosive sublimate
solution; employees
wear wet sponges
over mouth and nos­
trils when unloading
these hides.

____do.............................

Full recov­
ery (5 weeks
2 days).
Antianthrax serum___ No informa­
tion.

No. 12. 3 or 4 cases in
raw - skin
d e p a rt­
ment or in
beam house.
No. 13. B e a m s te r At Newark City Hos­
engaged in
pital.
trimming
hides.




Full recov­
ery.

Doctor in attendance
every morning for
treatment of minor
accidents.
Rubber gloves.

45

AN TH RAX AS AN OCCUPATIONAL DISEASE.
T able

5 .—A N T H R A X CASES R EPO R TED B Y N IN E T E E N T AN N IN G A N D L E A T H E R ,
M ANUFACTURING ESTABLISH M EN TS—Concluded.

Location.

Firm.

Occupation
of victim.

Treatment.

Result.

Precautions now taken

New York:
No. 14. Unloading A t Johnson City Hos­ Fatal.. .
Hides whitewashed at
pital.
shipping point; bales
hides.
Repairman.. At Mead's Hospital, Full recov­
c o n ta in in g hides
Endicott, N. Y .
whitewashed; hides
ery.
soaked in solution of
H a n d li n g ........do.............................. ........do...........
mercury at tannery.
hides.
Beamster___ ........do.............................. . . do........
*
Unloading ........do..............................1........do...........
hides.
Gloversville. . . No. 15. Beamster___ At home........................ ........do........... Gloves to employees in
beam house.
No. 16. Raw - skin ........do............................. ........do........... Raw material naphthalened; solution of
trimmer.
weak lime liquor for
Bagging hair ........ do............................. Fatal............
washing hands.
from raw
material.
Pennsylvania:
Corry................. No. 17. 2 cases; occu­ At hospitals.................. Full recov­ Antiseptic solution for
washing hands.
pation not
ery.
given.
Elkland............ No. 18. H a n d lin g At home........................ ........ do........... Antianthrax serum on
hand.
hides in
beam
house.
........do...........
do............................ ........ do...........
Various tanneries.. No. 19. 27 cases; oc- Not given...................... ........do........... Immediate care of all
wounds; inquiry as
c u p ation
to cause of illness if
not given.
absent.
3 cases; oc- ........ do............................. Fatal............
c u p ation
not given.

O f the 70 cases here reported, in 41, or more than half, no in for­
mation as to occupation is given. O f the remaining 29 victims, the
m ajority (16) were beamsters or beam-house workers, while only 6
are reported to have been working on dry hides. This is apparently
a reversal o f the ordinary tannery situation, but may be partially
accounted fo r by the unusually large proportion o f cases in which
the occupation is not given. Other workers affected were a sweater,
a flesher, a raw-skin trimmer, one engaged in bagging hair from raw
material, and a repair man. Particularly striking is the case o f the
3-year old daughter o f a beam-house employee, to whom the bacillus
was probably carried on her father’s clothing.
Inform ation with regard to sanitary precautions, given by the 19
tanneries and leather plants which reported cases, is unusually full.
Prophylactic measures ranged from the mere furnishing o f a disin­
fecting wash for the men to daily examination o f all employees and
even discontinuance o f the use o f the more dangerous materials. In
addition to these 19 plants, 54 which reported no cases indicated
that they took precautions as fo llo w s:
Instruction to employees o f danger____________________________
Immediate treatment o f wounds_______________________________
Furnishing o f gloves____________________________________________




10
21
23

46

BULLETIN OF TH E BUREAU OF LABOR STATISTICS,

Furnishing o f respirators.
Employ physician
Employ nurse
D isinfect hides before handling.

2
1
2
6

D uring the summer o f 1916 the National Tanners’ Association took
up the question o f more thoroughly disinfecting their plants to
guard against contagion from imported hides. U pon applying to
the Bureau o f Anim al Industry fo r suggestions as to how to proceed
with the work, the tannery owners were advised that “ next k fire,
to
bichloride o f mercury appears to be the most efficient agent in the
sterilization o f the anthrax spore.” The bureau therefore recom­
mended that all parts o f the premises be thoroughly sprayed with a
1 to 1000 bichloride o f mercury solution, then scraped and swT
ept
(the debris being carefully burned), next scrubbed with the same
solution, and finally given another spraying with it, which should be
allowed to dry in. Special warning was issued against continuous
wetting o f the hands or clothes with the solution, in order to avoid
mercurial poisoning .2
F A T A L CASES REPORTED IN REGISTRATION A R E A OF THE UNITED STATES,
1910 TO 1917.

D uring the eight years from January 1,1910, to December 31, 1917,
no fewer than 222 persons were officially reported as dying, from
anthrax in the United States registration area, which covers less
than two-thirds o f the total population o f the country .3 W ere com­
parable inform ation available for the entire country there is no doubt
that this total would be considerably augmented. In Texas, for in­
stance, during the years 1912 to 1915 there were reported to the State
board o f health four deaths, none o f which appears in the United
States list o f 222, presumably because they occurred in outlying
districts not included in the registration area. Although 12 Kansas
1 Of the 742 wool dealers or wool manufacturers who replied to the circular letters
previously mentioned, the replies of eight indicated that precautions were taken to prevent
anthrax. Two establishments reported cautioning their employees to give immediate treat­
ment to cuts and scratches, besides using exhaust fans to carry off the d u s t ; one mill
posted notices warning employees not to neglect wounds ; four concerns used exhaust fans ;
and one manufacturer of wool yarns stated that he disinfected hides before handling.
2 For full text of the bureau’s communication, see Journal of the American Leather
Chemists’ Association, September, 1916, pp. 510, 511.
8 The registration area in 1913 included 24 States— California, Colorado, Connecticut,
Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi,
Montana, New Hampshire, New Jersey, New York, North Carolina (cities which had
1,000 or more inhabitants in 1 9 0 0 ), Ohio, Pennsylvania, Rhode Island, Utah, Vermont*
Virginia, W ashington, and W isc o n sin ; and 41 additional cities— Birmingham, Mobile,
and Montgomery, Ala. ; W ilm ington, D e l.; Jacksonville, K ey W est, and Pensacola, Fla. ;
Atlanta, Augusta, and Savannah, Ga. ; Aurora, Belleville, Chicago, Decatur, Evanston,
Jacksonville, Quincy, and Springfield, 111.; Atchison, Coffeyville, Fort Scott, Hutchinson,
Independence, Kansas City, Lawrence, Leavenworth, Parsons, Pittsburg, Topeka, and
Wichita, Kans. ; New Orleans, L a .; Lincoln and Omaha, N e b r.; Portland, Oreg. ; Charles­
ton, S. C. ; Memphis and Nashville, Tenn. ; El Paso, Galveston, and San Antonio, T e x .;
and Wheeling, W . Va. The population covered at that date was 63,298,718, or 65.1 per
cent of the total.




A N T H R A X AS A N O CC U P A TIO N A L DISEASE.

47

cities are so included, a farmer reported to the State board o f health
as having died o f anthrax in 1915 is not among the cases known to
the Census Bureau. Similarly a certificate o f death from the pul­
monary form o f the disease, filed with the Iow a health department,
did not get into the Federal statistics because Iowa is entirely out­
side the registration area. D uring 1918 and the first half o f 1919,
also, at least 36 deaths from anthrax are known to have occurred, 32
o f them having been officially reported to the Census Bureau. In 18,
or h alf o f the 36 cases, the probable source o f the disease can be
traced through the occupation or other facts given. Three were
tannery hands (one repairing hide vats), two were brush makers
(one a m anufacturer), one a rawhide cutter, two shoemakers, two
shoe dealers, one a machinist in a hairpicking plant, one a freight
handler, one a cattle ranch hand, and five farmers. In five addi­
tional cases the occupation, w hile not so closely connected with the
T
disease, is still indicative o f a possible source o f contagion. These
include a textile operative, a plumber’s helper in a textile mill, a
clothing factory operative, a tailor, and a drayman. In the remain­
ing 13 cases no clear occupational causation can be traced from the
data available, since they occurred, respectively, in a bookkeeper, a
machinist, a “ m ill man,” a cook, a conductor, a shipyard laborer, a
restaurant'keeper, a village assistant postmaster, three “ laborers,”
and two persons whose occupations were not given. This inform a­
tion is, however, scattered and incomplete, and it has been -thought
best to confine this section o f the study to those fatalities officially
reported to the United States Bureau o f the Census for the eight
years specified.
D IS T R IB U T IO N

OF

IN D U S T R Y ,

PLACE

OF

DEATH,

ETC.

O f the 222 persons officially reported as dying o f anthrax during
this eight-year period, 50 were designated on the death certificates
merely as “ laborers,” a very unsatisfactory classification; 6 others
were designated as “ laborer, clay,” “ laborer, paper mill,” “ laborer
in tannery,” “ laborer, m orocco works,” u laborer, freight yard,” and
“ laborer, longshore ” ; 23 as farm ers; 14 as housewives or house­
keepers ; 7 as morocco w orkers; 6 as stevedores or longshorem en; 4
as curriers; 3 as leather w orkers; 3 as carpenters; 3 as “ at school ” ;
2 as tanners; 2 as brush m akers; 2 as peddlers; 2 as teamsters; 2 as
freight handlers; 2 as barbers; 2 as tailors; 2 as merchants; 2 as
physicians; 2 as hair cloth makers; and 2 as young single women
6 at home.” The follow in g designations occur once each: H andling
4
dry hides, tannery worker, w orking in tannery, chemical worker in
tannery, stationary engineer in morocco works, ripper, shoeman,




48

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

w ool washer, woolsorter, m ixing hair, bristle comber, broom and
brush maker, m ill hand in carpet factory, paper mill hand, foreman
in mill, freight agent, driver, switchman, weigher, rancher, ranch
foreman, sheepman, cowboy, farm hand, rice farmer, gardener, veteri­
nary surgeon, hair dresser, cook, baker, cake baker, candy packer,
cigar maker, retired cigar maker, chair maker, painter, steamfitter,
molder, printer, mechanic, foreman, electrical supply salesman, sales­
man, stenographer, domestic, retired pilot, fisherman, retired;
farmer, watch maker, musician, lawyer, druggist, medical student,
liveryman, and undertaker. Ten o f the deceased were reported to
have had no occupation, in 1 case the occupation was said to be
“ unknown,” and in 15 cases no inform ation on this point was given.
Other data on the certificates, however, show that these last 26 per­
sons included two who were old men, aged 81 and 60, respectively,
three boys aged 15, 7, and 3, a little girl aged 6, and fiye infants o f
1 year or younger.
In a few cases in which the statement o f occupation given on the
official death blank did not agree with more precise inform ation
subsequently obtained from other sources the real occupation was
without significance as regards causation o f the disease. Thus one
woman who was reported as a cigar maker had left the bench at the
time o f her marriage, 30 years before she died. One woman who was
stated to have no occupation was acting as a housekeeper and nurse,
and another was a teacher. A man reported as a lawyer had retired
and had no active occupation except caring for his own country
home.
On the other hand, in other cases investigation brought out occu­
pational inform ation o f great significance. Thus, the man reported
as a weigher was employed by the Federal Government in the cus­
toms service and had been weighing hides and skins from South
America. One o f those reported as freight handler worked on the
wharves and was really a longshorem an; the other is actually known
to have been unloading hides. The steam fitter and one o f the car­
penters were employed around tanneries. The man reported as a
m older was not engaged at his trade, but fo r six months previous to
death had been a limer and general helper in a leather factory. The
man reported as an undertaker had given up his business to become
an employee in a tannery establishment, where he received and
checked imported horsehides. The ripper was a ripper o f raw skins
in a kid-leather factory, and the “ shoeman ” was a lime handler in
a tannery. The salesman and one o f the peddlers were found to be
selling brushes, and the “ merchant ” was a farmer who canvassed
fo r an animal fertilizer company o f which he was a director. One
young woman who was reported as staying at home helped on her




A N T H R A X AS A N O C CU PATIO N AL DISEASE.

49

father’s dairy farm ; two more women designated as housewives are
believed to have contracted the disease from a sheep and a cow,
respectively, which had died o f anthrax a few days before; a boy
whose occupation was not stated did chores about hom e; so that all
fou r o f these persons may appropriately be classed as farmers. One
person whose occupation was given as “ none ” was in reality a
bristle handler and brush maker. One fo r whom no occupation was
given was engaged at some task which brought him in contact with
a sick cow, while a second was a clothing operator sewing woolen
trousers. Another, whose calling was said to be 6 unknown,” was a
6
laborer loading and unloading hides. Moreover, o f the 50 reported
merely as “ laborers,” it was found that 12 were tannery em ployees;
5 were farm or ranch hands; 5 were longshoremen or stevedores; 2
were freight handlers; 2 were curled-hair w orkers; 1 loaded wagons
with wool trimmings from hides; 1 was engaged on imported horse­
h air; 1 was a w oolsorter; 1 a watchman at a shoddy plant which
handled curled hair from a felt factory; 1 a driver who had been
unloading hides from a vessel; 1 a contractor unloading and loading
hides; 1 a worker in a m orocco fa c to r y ; and 1 a paper-mill employee.
In several o f the farm, longshore, or freight handling cases, in addi­
tion to those so described, a definite history o f contact with hides or
even with diseased animals was secured.
In brief, then, although in about 79 cases the connection between
occupation and disease is obscure or nonexistent, 143, or nearly twothirds o f the persons under consideration, were in occupations
where the menace o f anthrax, especially with the grade o f imported
animal materials procurable under war conditions, is well recognized.
F orty-tw o were hide-and-skin workers or were otherwise employed
about tanneries; 42 were farmers, ranchmen, or women living on
fa rm s; 25 were transportation em ployees; 19 worked with wool, hair,
or bristles, or acted as brush salesmen; 2 were rag handlers in paper
m ills; 2 were liverym en; 1 was a veterinarian; and 10 were laborers
whose duties were apparently connected with one or another o f
the foregoing branches o f industry.
T a n n i n g . — The largest single manufacturing occupational group
among the 222 recorded persons who succumbed to anthrax in the
United States registration area during the eight years 1910 to 1917,
inclusive, is composed o f tannery employees, o f whom there were 42.
W hile the available inform ation is too fragmentary to permit a posi­
tive statement, there is strong reason fo r believing that most o f these
42 workmen were engaged not in the late but in the earlier tannery
processes. Thus No. 105, one o f the cases given in detail on pages
66 to 98, was unloading at the factory dry South American and
141633°— Bull. 267— 20-------4




50

B U L L E T IN OF T H E BU REAU OF LABOR STATISTICS.

Chinese hides. Another (No. 80) was a checker and receiver, and
dealt with Russian horsehides. A third (N o. 35) had been employed
fo r two years as an assorter o f hides. T w o (Nos. 158 and 188) are
described as a tannery worker handling hides and a laborer in the
raw-stock department o f a leather factory handling horsehides, while
still another (No. 166) was a ripper o f raw skins in a kid-leather
factory. Only with the next man (N o. 58), who was a limer and
general helper, do we come to an actual tanning process, and even
he, at the time o f his infection, had been helping store away raw
sheepskins. Connected also with the lim ing process were a lime
handler (No. 178) and a laborer (No. 149) who removed hides from
lime vats. One man (No. 87) was a skin washer, one (No. 160) a
piecer and trimmer in a leather works, and another (No. 50) was a
“ lumper ” in the coloring room o f a m orocco and calfskin factory.
This last operation, which occurs well along in the tanning process,
is the latest one mentioned in any o f these cases. Special note should
be made o f the circumstances that one tannery employee (No. 1 ) who
died was a carpenter, one (No. 185) a steam fitter ,1 and a third (N o.
54) a stationary engineer. Another man (No. 221) unloaded car­
boys o f chemicals at a tannery. The remaining 26 tannery employees
(Nos. 2, 3, 5, 10, 20, 41, 49, 69, 74, 93, 94, 97, 103, 128, 131, 137,
139, 148, 161, 163, 170, 184, 205, 208, 209, and 216) are described
merely as “ tanner,” u currier,” “ laborer in tannery,” “ morocco
worker,” or by some similarly indefinite term ; but, judging from
the experience in the groups o f local cases previously examined ,2 it
is reasonable to believe that many o f these were porters, warehouse­
men, and the like, who handled the hides in the earliest stages, before
actual tanning had begun. T hirty-tw o o f the total number here
grouped as working at “ tanning ” are described as employed in tan­
neries or leather factories (i. e., establishments curing cow, horse,
and similar large hides), while the remaining 10 were employed in
morocco or kid works, where goat, sheep, and other light skins are
treated.
F a r m i n g a n d R a n c h i n g . — Equally large is the group comprising
farmers, ranchmen, sheepmen, or others engaged in similar pursuits,
who also numbered 42 out o f the total 222 fatalities. In nearly h alf
o f the cases (Nos. 8,18, 22, 48, 70, 71, 75, 104,124, 132, 143, 180, 190,
191, 194, 202, 217, and 220) the source o f infection remains unknown.
On the other hand, one young woman in the group (N o. 120) assisted
her father on his dairy farm. A boy o f 16 (No. 65) helped care fo r
his father’s cow and horse. A California farm laborer (No. 99) at
1 F or an additional case o f a steam fitter who contracted the disease in a tannery,
see p. 36.
2 See pp. 32 and 43.




A N T H R A X AS AN O C CU PATIO N AL DISEASE.

51

the time o f his attack handled cattle and cattle hides o f local origin.
A California woman (No. 33) who lived on a farm is believed
to have been infected indirectly from a dead sheep, and two other
deaths from anthrax occurred, one o f the decedents being the owner
o f a large sheep ranch (No. 134) and the other a farmer (No.
147) who had a herd o f diseased sheep. In the cases o f another
California housewife (N o. 84), o f a Verm ont farm hand (N o. 24),
and o f one man (No. 135) fo r whom no occupation was given on the
official death certificate, the contagion was traced directly to sick
cows, one o f which died. Five men (Nos. 12, 15, 26, 193, and
195) died after skinning cattle which had died o f disease, while
a sixth, a cowboy (No. 215), is believed to have been infected in
the same way. A rancher (No. 164) buried a calf which had died
o f anthrax, and a laborer (No. 207) had worked on a ranch 2 miles
from where anthrax deaths among cows had occurred. A W is­
consin farmer (No. 83) opened a cow to ascertain the cause o f its
death, and even dissected the characteristic black spots he found in
its abdomen. T w o men described as farmers were exposed to the
disease, one by being a caretaker o f stock (No. 200) and the other
(N o. 186) by treating a horse which died o f a severe infection. A
farm er (No. 150) and a rice farm er (N o. 219) were apparently bitten
by flies or mosquitoes. A “ merchant ” (N o. 199) turned out to be a
farmer who canvassed for an animal fertilizer com pany; he had also
fed diseased hog meat to his chickens. Particularly striking is the
story o f a New Y ork farmer (No. 78) who, according to the physician,
“ was in the habit o f buying up old and poorly nourished cattle,
butchering them, and selling them where lie could. W hile awaiting
trial on charges o f selling tuberculous meat this man apparently
slaughtered fo r sale an animal suffering from anthrax, and died as
a result.” The possibility o f acquiring the disease by eating the meat
o f anthrax-infected animals seems to be well recognized .1
L o n g s h o r e W o r k .— A t least 15 o f the 24 transportation workers re­
ported as dying o f anthrax were longshoremen at the ports o f Boston
(Nos. 43, 76, 108, 110,127,140, 179, and 181), Philadelphia (Nos. 56,
82, and 89), and New Y ork (Nos. 131, 167, 182, and 213). Probably
the Boston “ freight liandler ” (N o. 4) and the New Y ork “ laborer
and driver ” (No. 116) elsewhere discussed, also belong in this group.
Eleven o f the fifteen men unloaded hides, specified in various in­
stances as com ing from India, South America, and “ A m erica ” ; one
unloaded hides and w ool; one hair from China; one denies having
1 That the business methods of this man are not unprecedented is shown by the state­
ment of Rayenal that he had “ known an animal in the last stages of anthrax to be
slaughtered and dressed for market by a thrifty farm er who saw his eow about to die
and wished to avoid loss.
Examination of the blood of this anim al proved it to be
swarm ing with anthrax.”
(A rticle on Anthrax in M odem Medicine, 1907, Vol. I l l ,
pp. 42-51.)




52

B U L L E T IN OF T H E BU REAU OF LABOR STATISTICS.

handled either hides or w ool; and the nature and source o f the ma­
terials handled by the other are not stated. The death-bearing hides
are known in two cases to have been dry. These hides arrive some­
times in large burlap-wrapped bales, sometimes loose. In either case
the labor o f fastening tackle upon them, hauling them from the
hold, and lugging them onto the pier offers m anifold opportunities
for abrasions and scratches o f the skin, which readily become infected
by the spore-ladened hides or the dust therefrom. (See cut facing
this page.) Seven o f the lesions in this group appeared on the neck,
five on the face, one was internal, and the position o f two is not given.
In one o f these cases application fo r indemnity was made under the
Massachusetts workmen’s compensation law, but was denied on the
ground that the infection occurred while the workman was in the
employ o f a steamship line other than the one named in the appli­
ca tio n /
C u s t o m s W e i g h i n g .— A case (No. I l l ) which brought into strik­
ing relief the inadequacies o f the Federal employees’ compensation
act o f May 30,1908, was that o f a Government weigher in the customs
service. This man’s duties included tearing open the bales o f hides,
examining their contents, and weighing them.
(See cut facing
page 53.) Just before fallin g ill he had worked on hides and skins
from South America. His widow, though left with three small chil­
dren, was unable to secure indemnity from the United States Goviernment because customs weighers were not covered by the act. Sev­
eral attempts to secure the passage o f a special relief bill appropri­
ating two years’ pay for the widow and her children also failed o f
passage.
T r u c k D r i v i n g .— Three more transportation workers whose at­
tacks o f anthrax proved fatal were truck drivers or teamsters. One
(No. 116) was reported as a laborer and driver; he had, however,
fo r a week preceding illness, been “ unloading hides from a vessel,”
so that, as previously stated, he probably belongs among the long­
shoremen. In his case the anthrax papule appeared on the chest.
T w o others were teamsters, one (No. 144) handling and weighing
dried hides, the second (No. 183) handling goatskins in bales. In
this connection might be mentioned the man (No. 221), already dis­
cussed under “ Tanning,” who had been a tanner but who at the time
o f infection was a driver fo r a chemical company and had delivered
carboys at a tannery.
F r e ig h t
H a n d l i n g .— F our additional fatal cases occurring in
transportation work were those o f freight men. One (No. 61) was
an agent. He worked in a small inland Pennsylvania town, but




1 See pp. 109 and 111.




PL AT E 6.—U N L O A D I N G A C A R G O OF H I D E S F R O M S O U T H A M E R I C A .




P L A T E 7.—W E I G H I N G D R I E D C A T T L E H I D E S I M P O R T E D F R O M S O U T H A M E R I C A .

A N T H R A X AS A N O CCU PATIO N AL DISEASE.

53

nevertheless contracted anthrax from handling imported hides. One
was called a handler. H e was, however, most likely a Boston long­
shoreman. His infection was on the right arm. Tw o others, both
called “ laborers,” worked along railroads. The first (No. 146) is
said to have loaded ties and wood on railroad cars, while the second
was a contractor loading and unloading hides fo r further shipment.
One man whose occupation was given as “ unknown ” turned out to
have been engaged at unloading and loading hides from Brazil and
Argentina (No. 133). Still another transportation worker known
to have died o f anthrax (No. 211) was a railroad switchman. No
definite origin o f infection is recorded, but among the possibilities
the physician names contact with freight cars.
B r i s t l e a n d B r u s h W o r k e r s .— A remarkable feature o f the his­
tory o f anthrax in the United States is the sudden eruption, after the
beginning o f the war, o f cases in the bristle and brush industry. In
other countries the dangers in this industry had been well known and
were guarded against, but they did not attain prominence in America
until the interruption o f normal trade movements by the European
conflict led to the importation here o f quantities o f bristles from
areas where sanitary requirements were less exacting. O f the seven
anthrax deaths occurring in the bristle and brush trade during the
eight years under discussion, six took place in the last two years, 1916
and 1917, and as pointed out on page 47 further fatalities o f this type
were already on record fo r the subsequent period. One o f the fatal
cases was that o f a man (No. 38) employed as a bristle comber and
hair dyer. The materials he worked with came from Siberia. Tw o
were brush makers (Nos. 155 and 174), one was a broom and brush
maker (No. 159) ? and one (No. 169), whose occupation was officially
given as “ none,” was a bristle handler and brush maker. Particu­
larly striking because o f the remoteness o f their occupations from
actual contact with bristles in shop processes are the deaths o f a
peddler (No. 156) and o f a traveling salesman (No. 212) who carried
brushes.
H a i r W o r k i n g a n d W e a v i n g .— Seven deaths occurred among per­
sons who were engaged in various processes connected with hair
working and hair weaving. One (No. 55) had been employed fo r
only eight months as a laborer in a curled-hair factory using large
quantities o f imported material. Another (No. 152) was a laborer
in a curled-hair factory. A third (No. 141) was a laborer working
on im ported horsehair. Others in this group were a man (No. 17)
who mixed animal hair in machines preparatory to spinning, a hair­
cloth maker (No. 63) who was taken fatally ill after working over a
bale o f Siberian hair, and an employee (No. 106) in a carpet factory
where the coarser grades o f hair are woven. Finally, one o f the




54

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

more unexpected victims was a watchman (N o. 145) at a shoddy
works which handled curled hair from a felt factory.
W ool W ashing and S orting.— W ool washing and sorting and re­
lated work appear to have claimed five victims. The wool washer
(N o. 136) came in contact with skins from South America. One
(No. 142) was foreman and woolsorter in a woolen m ill; another
woolsorter (N o. 173) was employed by a wool-scouring concern.
A fourth man (No. 7) came in contact with raw American sheep
wool, and, according to the physician’s statement, was probably a
woolsorter. In this work the bales o f wool are first placed on racks
over steam pipes, which heat the wool and soften the natural grease
it contains so that the fleeces can easily be opened out. The work­
bench has a top o f wire screen, through which the dirt and im puri­
ties drop, and within easy reach are a number o f baskets or crates,
one fo r each grade o f w ool which is to be separated. (See cut
facing p. 55.) Usually the only tool is a pair o f woolsorter’s scissors,
fo r clipping off tar and other matter wT
hich may be found adhering
to the fleece. The whole process is very simple, but gives rise to
large quantities o f dust, the fine particles o f which form convenient
vehicles fo r the anthrax spores. Closely related to these deaths is
that o f a Philadelphia “ lab orer” (N o. 218) whose work consisted o f
loading wagons with wool-trimmings from hides.
P a p e r M a k i n g . — T w o o f those who died with anthrax symptoms
handled rags in paper mills. One (N o. 11) unloaded baled rags
from cars and trucked them into the storage sheds and to the cutting
rooms, where the rag cutters would open the bales and feed the rags
into the cutting machines. The other (No. 14) was engaged as a
bleach boy in the rag room. Both workers handled large quantities
o f imported rags from such countries as England, Ireland, Germany,
France, Italy, and Spain.
L i v e r y m e n .— T w o o f the deaths (Nos. 67 and 95) were among
liverymen. The form er had a pustule on the lower lip, which at his
request was opened with a penknife by a relative. The penknife,
however, had previously been used by the patient to incise what he
considered an “ abscess ” on one o f his horses, so that the physician
is not certain whether the case was anthrax from the start or whether
inoculation occurred through the knife. The knife had disappeared
and could not be examined fo r anthrax bacilli.
V e t e r i n a r y S u r g e r y .— One o f the most interesting cases o f fatal
anthrax (No. 47), from the clinical point o f view, which was dis­
closed in this study was that o f a veterinary surgeon. Some 12 days
before becoming alarmed over his condition he had perform ed an
autopsy on some cows, in the course o f which he scratched his fore­
finger. H e cauterized the scratch and nothing developed there, but







P L A T E 8.—A “ D R U M " IN W H I C H S K I N S A R E C H U R N E D , IN O R D E R T O S O F T E N A N D R E M O V E W A S T E M A T T E R .




P L AT E 9.—W O O L S O R T I N G .
In w o o l m a n u f a c t u r i n g c e n te rs o c c u p a tio n a l a n t h r a x

is c o m m o n l y k n o w n

as “ w o ol so rte rs’ d ise a se .1

A N T H R A X AS A N O C CU PATIO N AL DISEASE.

55

he probably scratched himself at the same time on the other wrist,
for a week later there developed in that location the pustule which
caused his death.
B a r b e r s a n d H a i r d r e s s e r s .— Two of the 132 persons dying of
anthrax (Nos. 21 and 77) were barbers and one (No. 40) was a hair­
dresser. A ll were men. In none of these cases were details obtain­
able, but a possible source of infection is indicated by the evidence
presented on page 23 regarding infection through shaving brushes.
Early in March, 1916, also, the New York city bureau of public
health education received a communication from Dr. A. K. Chambers,
health officer of Glasgow, Scotland, stating that two shipments of
London-made shaving brushes had been received in Glasgow and that
each brush had been found to contain anthrax germs. The New York
health department thereupon announced that all future importations
o f shaving brushes would be thoroughly examined for the presence
o f the germs.
A r m y C o o k . — One fatal case (No. 214) occurred in an Army cook
at Camp Upton. Shortly after the first drafted men reached the
cantonments reports of anthrax, spread among them by shaving
brushes, came from many localities. So serious was the menace that
the United States Public Health Service issued broadcast repeated
warnings urging purchasers o f cheap shaving brushes thoroughly
to disinfect them before using.1 The case here noted may have
originated from one of the infected brushes.
L a b o r e r s .— In 14 fatal cases the occupation of the deceased is ob­
scured under the vague designation tc laborer.” Four of these deaths
(Nos. 101, 102, 157, and 210) took place in Pennsylvania tannery
towns; a fifth (No. 29) occurred in a Massachusetts city with large
shoe works as well as tanneries; and a sixth (No. 34) took place in
Philadelphia, where in both hair works and tanneries the risk of
occupational anthrax is great. One (No. 196) appears, from the
time and place, to be identical with the decease o f a farm helper
mentioned in the history of another death from the same farm.2
In these cases what the victims worked at can be surmised with ap­
proximate accuracy, but in the remaining seven (Nos. 25, 31, 42, 91,
109, 172, and 204) there is no clue whatever. From the standpoint
both o f accurate morbidity statistics and of efficient prevention of
occupational disease, such loose reporting should be discouraged.
M u s i c i a n .— One man (No. 30) was a traveling musician, and at
the time o f his death is believed to have been with a circus. As he
was fond o f horses it is suggested that he may have contracted the
disease from one o f the circus animals.




1 See p. 148.

8 See p. 95.

56

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

H o u s e k e e p i n g . — Sixteen of the fatalities reported as from anthrax
occurred among women who were acting as housewives (Nos. 6, 9, 39,
53, 57, 68, 85, 96, and 119), housekeepers (Nos. 28, 52, 151, and 153),
housekeepers and nurses (No. 66), domestics (No. 62), or (No. 92)
simply living “ at home ” with no definite occupations. In no case
is the source o f infection indicated.
I n f a n t s . — Five o f the reported victims o f anthrax were infants
1 year old or less. In three o f these cases (Nos. 16, 73, and 88) the
mode o f infection is unknown. A girl baby o f 4 months (No. 64)
was struck on the mouth with a fly swatter in the hands o f an older
child who was tending her, breaking the skin and perhaps intro­
ducing the fatal bacillus or spore from a fly which had previously
been killed with the implement. The physician’s history in the
remaining case (No. 98) is most convincing. This little boy, aged 1,
lived on a farm. He was scratched on the leg by the teeth o f a pet
clog with which he was playing. The dog had been feeding on the
unburied carcass o f a calf that had died of anthrax. A pure culture
o f anthrax was taken from the child’s leg.
No O c c u p a t i o n . — O f the 10 persons who, according to the official
death blanks, had no occupation, 7 are elsewhere considered. Two
(Nos. 32 and 168) w ere men aged 38 and 35 years, respectively, the
T
other (No. 79) a girl of 14. In none of these cases could additional
information o f importance be secured.
O c c u p a t i o n N o t S t a t e d . — In 10 cases the occupation was not
stated on the official death certificates and could not be determined
from other sources. Three o f these (Nos. 138, 171, and 203) were
boys aged 15, 3, and 7 years. Three (Nos. 81, 86, and 117) were men,
aged 52, 54, and 52 years, respectively. One (No. 107) was a girl
6 years old, the discharges from whose nose contained a bacillus
“ having all the characteristics of the B a c i l l u s a n t h r a c i s .” The other
three were women. One (No. 113) was on a visit to New Y ork when
she pricked a pimple on her lip with a needle. The records for the
remaining two (Nos. 13 and 37) are brief and afford no clue to the
cause o f the disease.
M i s c e l l a n e o u s C a s e s , O c c u p a t i o n N o t S i g n i f i c a n t . — There re­
main 37 recorded victims o f fatal anthrax attacks whose occupations,
as given by the official death certificates, checked up from other
sources, bear no visible relation to the disease and are too scattered to
be considered in groups. The cause of infection in a few o f these
has been roughly surmised. A tailor (No. 90) and a young woman
school teacher (No. 44) are believed by their physicians to have been
infected by insect bites. Three girls— a postoffice clerk (No. 115), a
candy packer (No, 121), and a stenographer for a pipe-making con­
cern (No. 175)— are thought by some to have contracted the disease




A N T H R A X AS A N OCCU PATIO N AL DISEASE.

57

from fur neck pieces or muffs, but this theory is opposed by medical
men o f high standing. A driver for a bread company (No. 162)
may, according to the physician, have been infected by u contam­
inated hay, although this was not proven.” A landscape gardener
(No. 176) may have been infected by contaminated ground, by
manure, or by a razor strop which had not been properly treated in
tanning. A steel-mill laborer (No. 189) is stated by his physician to
have bought a new shaving brush and subsequently to have cut his
chin with his razor. In the 28 cases still remaining no explanation
for the onset o f the disease has been offered.
P lace a n d D ate o f D eath .— Somewhat more than half the total
number o f deaths, or 115, occurred in the three States of Pennsyl­
vania, New York, and Massachusetts. The distribution by States in
detail was: Pennsylvania, 48; New York, 39; Massachusetts, 28;
California, 15; New Jersey, 10; Connecticut and Ohio, 9 each;
Delaware, 7; Kentucky and Louisiana, 5 each; Colorado, Indiana,
Minnesota, Missouri, and Wisconsin, 4 each; Michigan, North Caro­
lina, Texas, and Virginia, 3 each; Kansas, Maine, Maryland, Ver­
mont, and Washington, 2 each; Illinois, Montana, Nebraska, New
Hampshire, and Utah, 1 each.
Grouped by years, the deaths took place as follows: 1910, 22;
1911, 14; 1912, 17; 1913, 25; 1914, 19; 1915, 35; 1916, 28; 1917, 62;
total, 222. It will be noticed that the last year named had within
1 o f as many cases as the two heaviest previous years combined, and
that these two years were those which immediately preceded it.
Considered by months, there appeared roughly to be a period o f
high frequency during March, April, and May, followed by a lull
in the summer and early autumn, and another high-frequency
period, even higher than the first, toward the close of the year. In
three o f the eight years the largest number of deaths in any single
month occurred in March or May; in three years it occurred in
November or December; and in the remaining two years the months
which had equally high numbers of fatalities were among these same
four. Whether this apparently regular fluctuation is accidental
only, or indicates a real variation in the risk o f infection, can not
yet be decided.
N a t i v i t y , A g e , S e x , a n d C o n j u g a l C o n d i t i o n . — One hundred and
thirty, or not quite three-fifths, of the persons who died of anthrax
in these eight years were born in America, and 77 of them died in
the States where they were born. There were also 16 Irishmen, 12
Russians, 11 Austrians, 9 Poles, 9 Italians, 8 Germans, 6 Canadians,
4 Englishmen, 3 Scotchmen, 2 Swedes, 2 Hungarians, 1 Frenchman,
1 Dane, 1 Greek, 1 Syrian, 1 Mexican, 1 Madeira Islander, 1 native
o f the Azores, 1 Bohemian, and 2 whose place o f nativity could




58

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

not be ascertained. Their ages ranged from 3 months to 81 years,
but more died between the ages of 31 and 40 and 51 and 60 than in
any other age decade. One hundred and eighty-eight were males
and 34 were females. One hundred and forty-one were married, 68
single, 10 widowed, 2 divorced, and 1 unknown.®
S T A T IS T IC A L S U M M A R Y .

The following table presents in chronological order the 222 deaths
recorded as from anthrax in the United States during the eight years
1910 to 1917, inclusive, showing the place of death, birthplace, con­
jugal condition, date o f death, age, occupation, and recorded cause
of death:
T a ble 6 . —D E A T H S FROM A N T H R A X R E P O R T E D IN T H E U N IT E D STA TES, 1910 T O 1917.

[Data drawn from official certificates of death.]

No.

Place of death.

Con­
Birth­ jugal D ate of
place. condi­ death.
tion.

Age.

Occupation.

1910
Jan.
2

Carpenter1.........

M.
M.

Jan.
Jan.
Jan.
Feb.
Mar.

Morocco worker.
Laborer2............
.......do 3...............
.......do 2 ...............
Housewife..........

M.
M.

Mar. 28
Apr. 1

Elmira, N. Y .

P a ...

M.

W ilmington, D e l--San Francisco, Calif.
Boston, Mass.............
Philadelphia, P a ---Jackson, Ohio...........

Germany
G reece..
Ireland..
England
O h io ....

M.
S.

Williamsport, Pa.
Pierceton, Ind___

I ta ly ...
In d ----

10
11
29
15
8

Laborer *..............
Law and farming.

Apr. 22 49 Cigar m aker5. . . .
9 Reading, P a .................. P a ...
June 4 17 Morocco w orker..
10 W ilmington, D e l......... D e l........ S.
Special inquiry disclosed that the actual occupation just prior to death was as—
1 Carpenter at tannery.
2 Laborer in tannery.
3 Freight handler.
« Worker w ith raw sheep wool; probably a woolsorter.
5 Housewife.

Cause of death.

Anthrax (external);
tetanus.
Anthrax.
Exhaustion; anthrax.
Anthrax.
Do.
Septicemia; anthrax
and Bright’s.
Anthrax.
Anthrax; heart fail­
ure.
Anthrax.
Do.

a B etw een th e b eg in n in g o f 1 9 1 8 an d th e fin al rev isio n o f th is rep ort in J u ly , 1 9 1 9 , 3 2
a d d itio n a l ca se s o f d e a th from a n th r a x had been disco v ered by clerk s in th e C ensus
Office in th e course o f th eir r o u tin e c o m p ila tio n o f d e a th c ertifica tes fo r th e in ter v e n in g
period. T he v ic tim s w ere, in c h ro n o lo g ica l order : O ccupation n o t g iv en , C hurch P o in t,
L a . ; cook, T am pa, F l a . ; laborer rep a irin g h id e v a ts in ta n n ery , Isla n d F a lls, M e .; d ra y ­
m an, N apa, C a lif .; farm er, L a J u n ta , C o lo .; te x tile o p era tiv e, L aw rence, M a s s .; shoe
salesm a n , N ew O rleans, La. ; m a ch in ist, C incinn ati, O h io ; sh o e cu tter, L ynn, M a s s .;
laborer, N ew York, N. Y. ; farm er, C arlisle, O h io ; ta ilo r, Spencer, Ind. ; ra w h id e cutter,
N ew York, N. Y . ; m ill m an, D a lla s, Tex. ; laborer, N ew O rleans, L a . ; fr e ig h t h an dler, N ew
York, N. Y. ; c lo th in g fa c to r y o p era tiv e, E a to n to w n , N. J . ; farm er, Selm a, La. ; farm er,
S elm a, L a . ; r e ta il sh o e dealer, B rockton, M a s s .; m a c h in ist in h a ir p ick in g pla n t, Gary,
I n d . ; Plum ber’s helper in t e x tile m ill, M ethuen, M a s s .; o ccu p a tio n n o t g iv en , A sh ley,
P a . ; resta u ra n t keeper, Chicopee, M a s s .; bookkeeper, Jefferson C ity, M o .; laborer, P h ila ­
d elp h ia, P a . ; condu ctor, N ew York, N. Y. ; c a ttle ra n ch hand, M okulua, H a w a ii ; farm er,
C row ville, L a . ; shoem aker, W eir, K a n s .; sh ip y a rd laborer, L os A ngeles, C a lif .; ta n n ery
hand, F a lls Creek, Pa. F u rth er fa t a l c a se s learn ed o f th rou gh o th er ch a n n els th a n th e
C ensus B u reau in c lu d e d : T a n n ery hand, Isla n d F a lls, M e .; brush m an u factu rer, N ew
Y ork, N. Y . ; b rush m aker, B rook lyn, N . Y . ; a s s is ta n t p o stm a ster, F red erica , D el.




A N T H R A X AS A N O CCU PATIO N AL DISEASE.

59

T able « . — D E A T H S FROM A N T H R A X R EPO R TED IN T H E U N IT E D ST A TE S , 1910
TO 1917— Continued.

Cass

No.

Place of. death.

Con­
Birth­ jugal Date of
place. condi­ death.
tion.

1910

A ustria.

M,

June 29

Howe, P a ...........

Canada.

M.

July 19

Philadelphia, P a .
Holyoke, Mass___

England W.
Mass___

Aug.
Aug.

La Junta, Colo.
Fairport, Ohio.

Scotland
Ohio___

M.
S.

Oct.
Oct.

Baltimore, Md.

Germany

M.

Dec.

Pomona, C a l...
Newcastle, P a .

111..
Pa.

M.
W.

Dec.
Dec.

Elmira, N . Y ..

N. Y ....

M.

Dec.

Fresno, Cal.

Germany

M.

Dec.

K ittery, Me..................

Me........

M.

Dee.

Canastota, N . Y ........... N . Y . . . .

M.

Jan. 27

Waterford, Y t.
Harrison, In d ..

M.
S.

Feb. 28
Apr. 28

M.
S.
M.

Apr. 28
May 7
May 16

V t ..
Ind.

N ew Orleans, L a ......... L a .........
Windham Co., Conn... Conn___
N ew Britain, Conn___ Ireland..

1911

29

L ynn, Mass........

30

Cleveland, Ohio.

31

Monterey, Cal. . .

Cal...

D.

July 10

32

Dubois, P a .........

Hungary

M.

July 28

33
34

Bakersfield, Cal..
Philadelphia, P a.

France..
A u stria.

M.
M.

Oct. 16
N ov. 7

35

.do..
Bohemia

S.

May 30

M.

June 21

W ilmington, D el.

P a .........

M.

Nov. 20

N ew Orleans, L a.

37

L a .........

S.

Dec. 27

Logan County, K y ___

K y..

M.

Feb.

M.
M.

Feb. 6
Feb. 13

Philadelphia, P a .......... P a .........
Mesopotamia, Ohio___ O hio___

Occupation.

1912

3

52

Laborer,
paper
mill.
___ d o ....................

Cigar maker (re­ Anemia; malignant
tired).
pustule,
r ig h t
cheek.
Laborer3
Anthrax.
....... d o . ..
Anthrax;
septice­
mia.
Farmer..........
Anthrax.
Tailor *..........
Do.
Housekeeper.
Anthrax (malignant
pustule); septice­
mia.
Laborer_
_
Anthrax; pulmonary
tuberculosis.
M usician5.
Malignant pustule;
edema of glottis.
Laborer___
Anthrax; acute ure­
mia.
None..
A n th rax; a n th r a x
edema.
H ousewife.
Anthrax.
Laborer___
Anthrax; due to ba­
cillus anthracis.
Assorter of hides, Anthrax.
morocco works...
Salesman, electric Anthrax (carbuncle);
supplies.
malignant pustule.
Not reported .
Bristle comber 6.
Housew ife..........

Hairdresser..........
Mar. 2
Md........ M.
Mar. 6
Morocco worker t.
Russian
Poland
Special inquiry disclosed that the actual occupation ju st prior to death was as1 Bleach boy in rag room of paper mill.
,
2 Handler of hides in leather company.
8 Farm laborer.
4 Tailor and presser.
5 Musician traveling w ith circus.
6 Bristle comber and hair dyer.
7 Morocco worker; probably in the beam houS3 a
Philadelphia, P a.
W ilmington, D el.




Cause of death.

Anthrax; septic in­
toxication.
Anthrax; skinning
cow dead w ith the
disease.
Anthrax; bronchitis.
8
60 N ot reported.
20
General sepsis; an­
15 Paper m ill1..
thrax.
46 Ranch foreman... Anthrax.
2
4 N one.................... Cramps—disease o£
13
mos.
bowel; anthrax.
62 Mixing hair (ani­ Toxemia; anthrax,
2
mal) in ma­
chines, prepar­
ing for spinning.
Farmer (retired).. Anthrax; senility.
8
Baker..................... Anthrax;
exhaus«
19
tion following dis­
ease.
M echanic2.
Anthrax, external,
22
and general tox­
emia.
Barber.
Anthrax,
followed
28
b y septic abscesses
and pyemia.
Farmer.
Septicemia v/ith ma­
29
lignant pustule.

Greensburg, Pa..

17

Age.

mstule;
heart paralysis.
Anthrax.
M alignant p u stu le
on right side of face;
abscess of right kid*
nev.
Anthrax.
Do.

60

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

T able 6 .— D E A T H S FROM A N T H R A X R EPO R TED IN T H E U N IT E D ST A TE S , 1910
TO 1917— Continued.

Place of death.

Con­
Birth­ jugal D ate of
place. condi­ death.
tion.

Toledo, Ohio___

O h io ....

Boston, Mass___
New York, N. Y
Cincinnati, Ohio

1912

Age.

M.

Mar.

7

57

Mass___

Mar.

9

26

N. Y ...
Ohio_
_

W.

June 2
July 23

Allegheny County, Pa. Ireland
Orange, N. J................. N. J ....

Auer. 6
Sept. 13

Richland, Mo.......
Philadelphia, P a.
Peabody, M ass...
St. Paul, M in n .. .

I n d ....
R ussia.
_
...d o _
Minn__

Oct.
Nov.
Nov.
Nov.

Graves County, K y ..
Ballard County, K y .

K y .......
Tenn...

Dec. 4
Dec. 23

Wilmington, D el.

Md........

Jan. 19

Philadelphia, P a.

Poland..

Jan. 23

D el..
W is.

Feb. 13
Feb. 15

52

14
14
18
20

1913

Occupation.

Cause of death.

Laborer.

E x h a u s t io n from
chronic c y stitis ,
blood poisoning;
a n t h r a x — malig­
nant pustules on
leg and hand.
L a b o r e r —lo n g ­ Septicemia; anthrax.
shore, i
JNot repi
Not reported 2___ Malignant pustule.
Retired pilot.
A nthrax or carbun­
cle; s e p tic e m ia
and asthenia.
Foreman...........
Anthrax.
Veterinary surgeon Inoculation b y an­
thrax bacilli, caus­
ing general sys­
temic poisoning.
Anthrax.
F arm er...
Do.
Laborer 3. .
Morocco 4.
Do.
A t school..
Malignant pustule;
blood poisoning.
Housekeeper.
Anthrax.
_
Housewife_
Do.

Gardner, Mass..

Mass. i ..

Apr. 12

Cascade, P a ___

P a .........

May

2

Morocco, station­ Malignant pustule.
ary engineer.
Laborer 5.............. Anthrax carbuncle
of neck.
Anthrax.
.......do.6 ................
Housewife............ Anthrax of right
hand.
Anthrax; edema of
Molder 7..
glottis.
Druggist.
Anthrax of the neck;
fatty degeneration
of heart.
Chair maker...
Anthrax infection of
face.
Anthrax.
Freight a g en t8

Racine, W is_
_

R u ssia ..

May

5

Domestic........

Philadelphia, P a ..
Wilkes-Barre, Pa.

Poland..
P a .........

M.
S.

Hennepin County,Minn M inn....
North Attleboro, Mass. Canada .
Windsor Locks, Conn.. C onn....

S.
W.
M.

Brighton, P a .......
Wilmington, D el.
Lincoln, Mo.........

P a .........
Ireland .
Mo.........

M.

Gates, N . Y .

N. Y ....

Sept. 29

Elyria, Ohio..

O h io ....

Oct.

7

Physician............

U nity, P a ___

P a .........

Oct. 22

N one....................

.......do...........................
S n o h o m is h County,
Wash.
Gloversville, N. Y ___

Ireland..

Mar.

1

Brooklyn, N. Y .

Ita ly---

Apr.

6

25
4
mos.
16
July 17
76
July 20
Aug. 5
49
May 9
May 28

Aug. 13
Aug. 23
Sept. 8

34
54

Haircloth maker.
Laborer9..............
None 10.................
Liverym an..........
H ousewife............
Morocco worker..
Farmer.................
N ot reported u _
_

Special inquiry disclosed that the actual occupation just prior to death was i
1 Longshoreman handling hides.
2 School-teacher.
3 Laborer in tannery. *
« Lumper in coloring room of morocco and calfskin factory.
6 Laborer in curled-hair factory.
« Longshoreman loading hides and wool.
7 Limer and general helper in leather-dressing establishment,
s Freight agent handling foreign hides.
9 General helper on small-fruit farm.
Housekeeper and nurse.
11 Chore-boy around home.




Malignant pustule on
face, also internal
in mouth; edema
of glottis.
Anthrax.
Malignant pustule.
Anthrax.
M alignantpustule.
Malignant pustule;
septicemia.
Anthrax.
Do.
Anthrax; metastatic
pneumonia.
Splenic fever; malign a n t facial an­
thrax.
Anthrax; c h r o n i c
nephritis.
Cholera in f a n t u m
and anthrax,

A N T H R A X AS A N O CCU PATIO N AL DISEASE.

61

T able 6 .— D E A T H S FROM A N T H R A X R EPO R TED IN T H E U N IT E D ST ATES , 1910
TO 1917— Continued.

No.

Place of death.

Con­
Birth­ jugal Date of
place. condi­ death.
tion.

Lycoming C ounty,Pa. N . Y --Hanford, Cal................. A z o r e s
Islands.
Boston, Mass.. .
Winchester, V a.
M d...
Union, N . Y .................

1913

52
33

Dec. 13
Dec. 20

23
46

Dec. 24

M.

Oct. 23
N ov. 11

N . J..

South Windsor, Conn.. Conn__
Camden, N. J . .............

M.

Age.

56

1914

N . J..

Jan. 16

14

Jan. 29

S.

47

Fremont, Ohio............. Ohio___

Mar.

9

52

S.
M.

Mar. 15
Mar. 20

30
55

Calexico, Cal................. Scotland

M.

Apr.

70

Philadelphia, P a.
Norfolk, V a ..........

Poland..
V a ...

M.
M.

.. .do.......
Apr. 11

Philadelphia, P a .
N ew Orleans, L a.

Germany
L a ...

M.

May 6
May 29

Philadelphia, P a.
Cincinnati, Ohio..

Md........
Ohio___

M.

60
3
mos.
June 17
35
Aug. 8
41

Lewiston, Me..

Canada .

M.

Aug. 19

H o llid a y sb u rg , Pa

W ilmington, P e l.

90

M.

Philadelphia, P a ......... N . C ___
Pleasant Prairie, W is.. 111....

P a ...
R u ssia ..

Sept. 10
Oct. 10

6

Brooklyn, N . Y . .

Germany

N ov. 25

McKeesport, P a.
Lincoln, N e b r ...

V a .......
Io w a ...

Dec. 8
. . . d o ___

Camden, N . J..

Poland..

Dec. 31
1915

Fort Morgan, Colo.
Fresno, Cal............

C anada.
Ita ly---

Mar. 29
Apr. 3

100
101

Hartford City, Ind..
W illiamsport, P a ...

Ohio___
A ustria.

Apr. 4
Apr. 25

102

Coudersport, P a ........... ...d o .......

May 12

103
104

38
54

.do.
N unda, N. Y ---

.do..
N . Y ___

M.

May 18
May 24

Special inquiry disclosed that the actual occupation just
1 Handler of dry hides in tannery.
2 Ranch laborer.
3 Longshoreman handling hides.
* Farmer who made a practice of butchering cattle.
6 Checker and receiver of horsehides in leather factory.
6 Stevedore unloading hair.
* Skin washer in leather factory.
s Longshoreman unloading hides.
9 Laborer in tannery.
10 Farm laborer handling cattle and cattle hides.
^ Schoolboy who also did chores around home.




53

Occupation.

Cause of death.

H a n d l i n g dry Anthrax; infection
upon the neck.
hides.1
Laborer2.............. . Anthrax.
Longshoreman3. .. Anthrax; toxemia.
Barber................... Blood poisoning, the
result of anthrax.
Farmer <................ A n t h r a x infection.
N one...................... Anthrax or malig­
nant pustule; tox­
emia.
Undertaker5......... Anthrax (malignant
pustule); infected
from h a n d l i n g
hides in a local
leather factory.
N ot reported....... . R li eu matis m ahd an­
thrax; pericarditis.
Anthrax.
Stevedore 6..........
Anthrax; general in­
Farmer................
fection.
H ousew ife........... Septicemia, almost
certainly due to an­
thrax in a cow.
.......d o ................... Anthrax.
Not reported....... . Anthrax (malignant
edema); toxemia.
Leather worker7.. Anthrax.
None...................... Anthrax at base of
spine; scrofula.
Laborer 8............... Anthrax.
Tailor and presser, Anthrax infection of
f a c e ; nephritis,
acute.
Laborer................ Endocarditis; chron­
ic rheumatism; an­
thrax.
A t hom e.............. Malignant pustule.
Morocco worker.. Anthrax; edema of
larynx.
Laborer 9.............. Anthrax; infection
bacillus anthracis.
Liverym an..........
Anthrax.
Housewife............ Septic infection due
to anthrax bacillus.
Laborer, morocco Anthrax.
works.

N one..................... Anthrax; measles.
Laborer10.............. Anthrax; due to ba­
cillus anthracis.
Merchant............. . Malignant anthrax.
53 Laborer................. Anthrax c a u s i n g
edema of larynx,
facial anthrax.
31 ....... do................... Anthrax, internal;
typical case of true
anthrax.
29 ....... do.9...... .......... Septic i n f e c t i o n ;
typical case of true
anthrax.
14 Farmer and stu­ Septicemia; aDthrax
dent.11
of back.
prior to death was as-

62

BU LLETIN ' OF T H E B U R E A U OF LABOR ST ATISTICS.

T ablh 6 . - -D E A T H S FROM A N T H R A X R EPO R TED IN T H E U N IT E D S T A T E S , 1910
TO 1917— Continued.

Case
No.

Con­
jugal Date of
condi­ death.
tion.

Place of death.

Occupation.

105

Endicott, N. Y .......

R ussia..

M.

1915
June 1

Tannery worker *.

106

Hartford, Conn.......

Poland..

M.

June

Mill hand, carpet
factory.

107

Brooklyn, N . Y ........

N . J..

S.

June 29

N ot

108

Boston, Mass...........

S.

July

4

Stevedore 2............

109

New Orleans, L a_
_

New
Bruns­
wick.
L a .......

S.

July

8

Laborer................

110

Boston, Mass...........

R u ssia ..

M.

..d o .......

Laborer,
yard.3

111

Manhattan, N. Y .........

7

freight

N. Y ...,

M.

July 29

Weigher *.............

112 Salt Lake City, U ta h .. N . Y . . . .
113

Manhattan, N. Y ......... Md.........

S.
S.

Aug. 24
Aug. 30

C arpenter...........
N ot reported.......

s.

114

N ew London, C o n n ... N. Y . . . .

Sept. 3

P rin ter................ .

115

Brentwood, N. Y ......... N. Y . . . .

Sept. 29

N one5.................. .

116
117

Manhattan, N. Y ......... U. S . . . .
Madison, N. Y ............. N . J . . . .

Oct. 7
Oct. 12

Laborer 6............. .
N ot reported....... .

118
119

Manhattan, N. Y ......... U. S . . . .
Blue Earth Co., M inn.. M in n ....

Oct. 15
Oct. 22

Lawyer 7.............. .
Housewife........... .

120

Bainbridge, N. Y ......... N. Y . . . .

Nov. 12

A t home 8..............

121
122

Manhattan, N. Y .........
Philadelphia, P a .........

R ussia. .
Scotland

s.

M.

Nov. 18
Nov. 20

Candy packer___
Cake baker............

123
124

Johnson City, N. Y . . . P a .........
Lewistown, M ont....... England

M.
S.

...d o ....
Nov. 21

Laborer in tannery
F arm h an d ...........

125

Kings County, C al. . . .

O hio___

M.

Nov. 26

Painter 9...............

126

N ew Brunswick, N. J .. Ita ly ---

M.

...d o .......

Laborer, clay w .. .

127

Chelsea, Mass................ Poland..

M.

N ov. 27

Freight handler...

128
129

Boston, Mass................ Ita ly —
Manhattan, N. Y ......... N. Y . . . .

M.
S.

...d o .......
Nov. 28

Laborer 11..............
Medical stu d en t...

130

W illington, Conn........ N. Y . . . .

S.

Dec.

5

A t sch o o l..............

131

Brooklyn, N. Y ...........

R u ssia ..

M.

Dec. 18

Laborer12..............

132

St. Paul, M inn............. Sw eden.

W.

Dec. 27

Farmer..................

Special inquiry disclosed that th e actual occupation just prior to death was as1 Worker in leather factory, unloading dry hides.
2 Longshoreman working in hold of vessel and unloading dried hides.
3 Laborer unloading dry hides at wharves.
4 Weigher in United States customhouse.
5 Clerk in post office.
. 6 Laborer and driver, and unloading hides from vessel.
7 Retired lawyer, caring for his own home.
8 Helper on father’s dairy farm, doing housework and milking.
9 Laborer with no particular kind of work.
10 Laborer working in clay pit.
11 Worker in tannery.
1 Laborer handling hides at docks.
2




Cause of death.

Bacillus
anthrax;
s e p t i c e m i a ; an­
thrax.
A nthrax infection;
genuine anthrax;
from initial ulcera­
tion of neck.
General a s t h e n i a
from anthrax in­
fection of nose.
Anthrax.
Acute n e p h r i t i s ;
edema of lungs;
bacillus anthracis;
septicemia.
Anthrax; neck in­
fection w ith bacil­
lus anthracis.
Anthrax infection of
neck.
Anthrax.
Pustula maligna on
under lip; pyemia;
anthrax.
Malignant pustule;
convulsions.
Malignant anthrax
edema.
Anthrax.
Poison from anthrax;
cardiac paralysis.
Anthrax.
External and inter­
nal anthrax.
Septicemia;probably
anthrax bacillus.
Anthrax.
Septicemia due to
malignant pustule
on hip; cirrhosis
of liver.
Anthrax.
Anthrax
infection;
septicemia.
Anthrax on back of
neck; exhaustion.
Cellulitis of neck;
sepsis;
anthrax;
v a lv u la r h ea rt
disease.
Anthrax; malignant
pustule.
Anthrax.
Malignant anthrax;
edema.
M alignant pustule;
general septicemia.
A n t h r a x ; edema
of glottis; acute
cardiac dilatation.
Malignant anthrax
(carbuncle) on back
of neck.

63

ANTHRAX AS AN OCCUPATIONAL DISEASE,
T able 6 .—DEATH S FROM A N T H R A X R EPO R TED IN THE U N IT ED ST A T E S , 1910
TO 1917— Continued.

Case
No.

Place of death,

Con­
Birth­ jugal D ate of
place. condi­ death.
tion,

Age.

Occupation.

133
m

Niles, Mich................... Unknown M.
Columbia Co., W ash... III....
M.

191 6
Jan. 17
Jan. 29

U nkn ow n1..
Sheepm an. . .

135
136

Hodgenville, K y .......... K y ...
Johnstown, N. Y ......... N . Y . . . .

W.
D.

Feb. 8
Feb. 13

Wool' washer,

137

Chicago, HI.

M.

Feb. 19

Tanner.........

Germany

Cause of death.

Anthrax; sepsis.
Probably anthrax;
clinical symptoms
all indicated an­
thrax.
Anthrax.
External a n th r a x ;
chronic nephritis;
myocarditis.
Gangrene upper por­
tion of stomach and
ascending
colon
from thrombosis of

sician found an­
thrax.
Anthrax.
M.
Do.
Laborer3..........
M.
Longshorem an4. .. Anthrax pustule of
the skin of the neck
w ith
associated
edema of the larynx
and meningitis,and
consequent
as­
phyxia.
Laborer s..........
A ustria. M.
Anthrax.
141 Philadelphia, P a ---Apr. 7
142 ....... d o.........................
Ireland.. M. .. .do---Foreman in m ill...
Do.
N. C . . . . M.
Anthrax, the febrile
143 Goldsboro, N. C .......
Apr. 10
Farm er.............
infectious disease
due to infection
w ith the bacillus
anthracis.
144 Boston, Mass................ Ireland.
Anthrax.
Apr. 16
Teamster e
145 Philadelphia, P a ......... P a .........
May 2
L aborer7..
Do.
146 St. James, Mo.............. M o...
Anthrax (carbuncle
May 19
M.
___do8___
on neck).
147 Glendale Springs, N . C. N. C . . . . M.
Anthrax or m alig­
May 21
F arm erynant pustule, a
genuine case of in­
fectio u s bacillus
anthracis.
148
Ireland.. M.
Anthrax pustule of
June 2 52 Currier..
the skin of the neck
w ith a s s o c ia te d
edema of the phar­
ynx and larynx
and consequent as­
phyxia.
149 Philadelphia, Pa
Anthrax.
Poland.
Laborer —
June 26
T e x ....
150 Beaumont, Tex..
M.
June 29
Farmer..........
Do.
151 Bordley, K y .......
Anthrax; pyem ia.
Housekeeper.
M. ...d o ......
K y .......
152 D etroit, Mich___
P a .......
S.
Anthrax; inoculated
Aug. 12
L aborer11—
with bacillus an­
thracis; he worked
in curled hair fac­
tory and only lived
about 4 days after
infection was dis­
covered.
153 San Antonio, T ex .
T ex.
Sept. 7
M.
Housework..
Malignant pustule.
154 Cascade, P a ...........
P a ..
M.
Sept. 30
Anthrax; b a c i l l u s
Laborer12. ..
anthracis inocula­
tion.
155 Brooklyn, N. Y ........... U. S . . .
W.
Oct. 21
27 Brush maker.
Cellulitis of face, an­
t h r a x in fe c tio n ;
worked in a brush
factory.
156 ___ d o ................
R ussia.
Peddler 13.
M.
Oct. 31
Anthrax.
157 Falls Creek, Pa.
P a ....... . M.
N ov. 26
Laborer...
Anthrax; bacillus an­
thracis.
Special inquiry disclosed that the actual occupation just prior to death was as—
1 Laborer loading and unloading hides.
7 W atchm an at. at shoddy vrorks which handled
W atchman shndr
2 Worker in some occupation involving contact
curled hair from felt factory.
w ith sick cow.
8 Laborer loading ties and wood on railroad cars.
3 Laborer in tannery.
9 Farmer w ith herd of diseased sheep.
4 Longshoreman unloading hides.
10 Tannery worker removing hides from lim e vat.
5 Laborer working on imported horsehair.
n Worker in curled hair factory.
6 Teamster handling and weighing dried hides.
Contractor loading and unloading hides.
13 Brush peddler.

138
139
140

N ew York, N . Y
Boston, Mass___
Chelsea, Mass___




U .S ..
Ita ly ___
Ireland..

Feb. 22
Mar. 9
Mar. 15

64

B U L L E T IN OF T H E B U REA U OF LABOR STATISTICS.

T able 6 .—D EATH S

Case
No.

FROM A N T H R A X R EPO R TED IN THE U N ITE D STATES, 1910
TO 1917—Continued.

Place of death.

Con­
Birth­ jugal D ate of
place. condi­ death.
tion.

Age

1916

158

North Adams, M ass. . . V t.

M.

Dec. 17

159

New Haven, C onn___ Conn—

M.

Dec. 24

160

Philadelphia, P a . . .

M.

Dec. 30

Austria .

Laborer1
54

Broom and brush
maker.

Laborer2................

1917

Jan. 8
Jan. 14
. ..d o .......

Laborer3................
Driver *...................
Working in tan­
nery.
Farm er3 ................
Laborer6................

161
162
163

Ursina, Pa...............
Brooklyn, N. Y ---Munising, Mich.......

P a .........
U. S . . . .
A ustria..

M.
M.
M.

164
165

Saguache Co., Colo..
New York, N. Y ---

Iow a--Ireland..

M.

Jan.
Jan.

166

Camden, N. J.......... .

P a.

M.

Jan. 31

37

167

Brooklyn, N. Y ----

Ita ly ---

M.

Feb. 10

53

Philadelphia, P a ---

R ussia...

M.

Feb. 12

N one......................

169

Cedar Grove, N. J . .,

N. J.......

M.

Feb. 16

N one9.....................

170

Newark, N. J .........

Hungary

M.

Feb. 25

Leather worker_
_

Richmond, V a........

V a.

Port Allegheny, Pa.
W eymouth, M ass...

Sw eden.
Mass___

M.
M.

Mar. 17
Mar. 24

Laborer.........
Woolsorter..

Chelsea, Mass..........

England

M.

Apr. 14

Brush maker,

M.

Apr. 23
Apr. 27
May 3
May 12

Stenographer10...
Gardener i i ..........
Laborer 12 ............
Shoeman 13 ..........

May 24

Freight handler u

May 26
May 27
May 30

Farm er...
L aborer^
....... d o 15

172
173

175
176
177
178

New York, N . Y .......... U . S. . . .
U.S....
___do........................
M exico..
Hutchinson, K an s..
Boston, M ass...........
Syria—
Chelsea, Mass..........

180
181
182

Poland.

O k la ....
Evansville, Ind.......
Ireland..
Boston, M ass...........
New York. N. Y ......... ...d o .......

M.
M.

Cause of death.

Occupation.

R ipper7.................
Longshorem an8. ..

Anthrax; complete
s u p p r e s s i o n of
urine after 2 days.
A n th ra x ; p a t ie n t,
worked in brush
factory; due to the
in fec tio u s febrile
disease due to in­
oculation w ith the
bacillus anthracis.
Anthrax;genuine an­
thrax due to bacil­
lus anthracis.
A nthrax infection.
A nthrax.
Anthrax, m alignant
pustules.
A nthrax.
Anthrax, infection on
neck, cause un­
known.
Anthrax (malignant
pustule of anus and
intestinal anthrax).
Anthrax, malignant
pustule.
Anthrax, dueto bacil­
lus anthracis.
Anthrax, infectious
bacillus anthracis.
Anthrax, bacillus an­
thracis, cellulitis
and edema of glot­
tis.
Septic pyemia from
carbuncle, anthrax;
malignant pustule.
A nthrax.
A nthrax, proved in
la b o r a t o r y from
culture taken after
death.
Anthrax; septicemia
secondary to pus­
tu le (anthrax) of
th e face; occupa­
tional infection.
A nthrax.
Do.
Do.
A nthrax, maglignant
pustule of neck.
A nthrax pustule of
neck w ith asso­
ciated edema of
larynx
(presum­
ably occupational
infection).
A nthrax.
Do.
Anthrax; malignant
pustule; acute alco­
holism.

Special inquiry disclosed that the actual occupation just prior to death was as—
1 Tannery worker handling hides.
2 Piecer and trimmer in leather works.
3 Tanner.
* Driver for bread company.
6 Rancher who buried calf dead of anthrax.
s Member of repair gang for elevated railroad company, but home because cf illness.
7 Ripper of raw skins in kid leather factory.
8 Longshoreman handling rawhides.
9 Brush maker, bristle handler.
i° Stenographer working for manufacturer of iron pipes.
Landscape gardener.
12 Laborer m railroad construction gang.
m Lime handler in tannery.
14 Freight handler unloading hides,
lswarehouse stevedore handling hides.




A N T H R A X AS A N O CCU PATIO N AL DISEASE.
jle

65

6 __ D E A T H S FROM A N T H R A X R E P O R T E D IN THE U N IT E D STATES, 1910
TO 1917— C oncluded.

Case
No.

Place of death.

183
184
185

Philadelphia, P a . .
Boston, M ass.........
Manchester, N. H .

Birth
place.

P a .........
Ireland..
M ass---

Con­
jugal Date of
condi­ death.
tion.

Occupation.

19 1 7

M.

June 2
...d o ......
June 6

Teamster i___
Currier...........
Steam fitter2.

M.

June 12

Farmer 3........

June 15

W atchm aker.,

186

Bow Creek, K ans..

Ohio___

187

Waltham, Mass_
_

Denmark

188
189

Camden, N. J ...
Pittsburgh, Pa.

R ussia..

M.

June 19
July 1

Laborer4..
.......d o ....

190

Long Branch, N. J ___

N. J..

M.

July 10

Farmer.

191
192
193
194
195

Roulette, Pa.................
Long Branch, N. J ___
San Francisco, C alif...
Shreveport, L a.............
San Francisco, Calif—

P a .........
U .S ....
P a .........
L a .........
Germany

M.
S.
M.
M
.*

July 18
July 19
July 30
Aug. 6
Aug. 7

.do..
Fisherm an.
R ancher5 ..
Farmer___
___ do.........

196
197
198
199

S on om a, Calif.................. I ta ly ...
C lym er, P a ....................... P a / , . . .
N ew Y o r k , N . Y ........... Austria
H a rn ey, M d ..................... Md.......

M.
M.
M.
M.

Aug. 8
Aug. 12
Aug. 16
Aug. 26

L aborer...
Carpenter.
(6) ..............
M erchant7

200
201

S acram en to, Calif..........
L ib e r ty , M o .....................

I ll........
T enn...

W.
M.

Sept. 3
Sept. 22

Farmer 8..
Physician.

202
203
204
205
206

L a Junta, C olo................
Cabarrus C o., N . C ........
C olchester, V t .................
W o b u r n , M ass................
N ew Y o r k , N . Y ...........

N. Mex.
N. C ...
Canada.
V a .......
R ussia.

W.

Sept.
Sept.
Oct.
Oct.
Oct.

Farmer..

207
208
209
210

G rid ley , Calif.................. M inn...
M ilw aukee, W i s ............. German}
W o b u r n , M ass................ Ireland.
E lk la n d , P a ..................... P a ..........

S.
M.
M.

211
212
213
214

X /ackaw anna, N . Y ___
M ilw aukee, W is .............
N ew Y o r k , N . Y ...........
B rook h a v en , N . Y ........

215
216

25
26
5
12
18

Laborer.
Currier...
Peddler.

Oct. 21
Oct. 22
Oct. 27
Nov. 4

Laborer 9............
Tanner...............
Leather worker..
Laborer..............

Austria
C alif...
U. S . . .
Austria

Nov.
Nov.
Nov.
Nov.

Switchm an.......
Salesman10.......

Salinas, C a lif...................
W o b u r n , M ass................

C alif.. . .
Madeira
Is.

Nov. 22
Nov. 27

Cowboy.
Currier..

217

Williamsport, Pa

Italy.

Nov. 29

Farmer................

218
219
220
221

Philadelphia, P a.
Beaumont, T ex ..
Portville, N. Y
Boston,

Ireland..
Ill..........
P a .........
V t.........

D ec. 3
Dec. 6
Dec. 7
Dec. 19

Laborer 11............
Rice farmer.........
Farmer................
Chemical worker,
tannery.12

222

Norwalk, Conn............. Conn___

M.

S.

9
10
17
20

Dec. 23

L on gsh orem a n .

Cook..................

15

A t sch ool.

Cause of death.

Anthrax.
Do.
Anthrax:
chronic
alcoholism.
Anthrax
infection
left cheek.
Infection of neck;
thrombus; malig­
nant pustule.
Pulmonary anthrax.
Septicemia following
infection by an­
thrax bacillus due
to a boil on throat.
Anthrax of jaw, in­
oculation of bacil­
lus anthracis.
Probably anthrax.
Anthrax.
Do.
Do.
Anthrax; septicemia;
accidental; infected
while skinning a
cow.
Anthrax.
Do.
Anthrax; sepsis.
Anthrax (malignant
pustule).
Anthrax.
Anthrax; inoculation
w ith the bacillus
anthracis; malaria.
Anthrax.
Edema; anthrax
Anthrax.
Do.
Anthrax due to the
bacillus anthracis.
Anthrax.
Do.
Do.
Malignant anthrax;
edema, laryngeal.
Anthrax.
Anthrax infection.
Anthrax.
Anthrax; origin of
infection unknown.
Anthrax.
Vagus paralysis, in­
fectious febrile dis­
ease due to inocu­
lation with bacillus
anthracis.
Anthrax of heart and
kidneys; asphyxia­
tion from edema.
Anthrax; septicemia.
Anthrax.
Do.
Anthrax pustule of
the neck with asso­
ciated edema of the
larynx, and septi­
cemia.
A nthrax of face.

Spec al inquiry disclosed that the actual occupation just prior to death was asi t samster handling goatskins in bales,
8 Caretaker of stock.
2 S earn fitter employed in tannery,
9 Farm laborer on ranch 2 miles from where an­
8 F trmer and stockman who treated his own and
thrax deaths among cows occurred.
10 Traveling salesman handling brushes.
nei^t bors' stock.
iborer in raw-stock department of a leather f ac11 Laborer who loaded wagons with wool trim­
mings from hides.
tory landling horsehides.
12 Laborer who unloaded from a truck carboys of
» E ancher who skinned a calf,
chemicals for a tannery.
®C othing operator, sewing woolen trousers,
7 f irmer who canvassed for an animal fertilizer
any of which he was a director.

141633°— B u ll. 267— 20-------5




66

B U L L E T IN OF T H E B U EEA U OF LABOR ST A TIST IC S.
Individual Histories e f Fatal Cases.

In this section a more detailed account is given of each of the
foregoing 222 cases of death from anthrax. The facts were secured
by correspondence and interviews with hospital authorities and with
attending physicians, supplemented in some cases by visits to the
family and friends of the deceased. By such inquiries many addi­
tional particulars were obtained which were important as throwing
light on the relation between occupation and cause o f death.
No. 1, o f Elkland, Pa., died at the age o f 39 on January 2, 1910, o f “ an­
thrax (extern al) ; tetanus.” H e was a carpenter at a tannery, and upon
contracting the infection from hides was sent to Elmira, N. Y., to be treated
by a physician who had previously practiced near Elkland and had had much
experience w ith anthrax. “ I think,” says the physician, “ he would have
recovered from anthrax if tetanus had not developed about tw o weeks after
the appearance o f anthrax sym p tom s; he liyed only 24 hours from the time
tetanus developed. Of course he probably would not have developed tetanus
if he had not suffered from anthrax first.” As near as the physician could
find out the diseased hides “ were imported from South Am erican countries,
and from cattle that had died o f anthrax.” The physician further states that
*in five years’ practice near Elkland he treated “ quite a number o f cases suffering
from anthrax contracted by em ployees handling hides ” at the tanneries o f three
neighboring towns, and that this was his “ first case that succumbed to the
disease.”
No. 2, o f W ilmington, Del., died at the age o f 50 on January 10, 1910, o f
“ anthrax.” He was a m orocco worker by trade.
No. 3, o f San Francisco, Cal., died at the age o f 24 on January 11^ 1910,
o f “ exh a u stion ; anthrax.” H e was a laborer in a tannery, where, according
to the physician, he became infected by hides. The illness lasted only three
days, and death occurred in a hospital.
No. 4, o f Boston, Mass., died at the age o f 34 on January 29, 1910, o f “ an­
th rax.” H e was a freight handler. H is right arm w as affected. Upon admis­
sion to the hospital an excision o f the affected area was made. Serum was not
used. A pure grow th o f anthrax bacilli was obtained from the blood. H e had
been in the hospital about a day when death occurred.
No. 5, o f Philadelphia, Pa., died at the age o f 32 on February 15, 1910, o f
“ anthrax.” For six weeks preceding his illness he had worked as a laborer
in a tannery. According to the hospital physician, the disease began three
weeks prior to his admission to the hospital “ w ith a small pustular eruption
on the face. N ext day the neck became edematous, until on admission the
whole neck Was purplish in color and doughy to the feel.” H e died on the
day he was admitted to the hospital.
No. 6, o f Jackson, Ohio, died at the age o f 68 on M arch 8, 1910, o f “ septi­
cemia ; anthrax and B right’s.” She was a housewife.
No. 7, o f W illiam sport, Pa., died at the age o f 51 on M arch 28, 1910, o f
“ anthrax.” The physician states that the man came in contact w ith raw
sheep w ool o f Am erican origin, and that he probably was a w ool sorter. T h e
disease took the form o f “ malignant pustule— external anthrax,” according to
the physician, who goes on to s a y : * He had all the classic symptoms, especially
*
a marked edema o f shoulder which spread to fa ce and breast. H e lived about
five days. Crucial incisions were made about shoulder and breast. No relief
was derived from this treatment.” Anthrax bacilli were found. A ntianthrax
serum was not available at the hospital where the patient was treated.







PLATE 10.—A "BEAM H O U SE ” IN A TANNERY.
Scraping hides taken from lime vats in which they have been submerged until the hair is loosened.




P L A TE 11.— “ F L E S H IN G ” H ID E S BY M A C H IN E .

A N T H R A X AS A N O C CU PATIO N AL DISEASE,

67

No. 8, o f Pierceton, Ind., died at the age o f 52 on April 1, 1910, o f “ a n th ra x ;
heart failure.” His occupation was law and farming, and death follow ed
within five days, the physician states, after “ bite o f fly.” A carbuncle ap­
peared on the cheek, w ith “ papules, pustule, vesicles, great induration.”
Phenol (carbolic a cid ) was injected and stimulants were given. When asked
whether antianthrax serum was injected the physician rep lied : “ N o ; none
to be had.”
No. 9, o f Reading, Pa., died at the age o f 49 on April 22, 1910, o f “ anthrax.”
According to the physician the patient “ was the mother o f a large fam ily, and
a hard-working housewife. She claim ed to become infected through an abra­
sion o f the skin o f the back. She was treated in the beginning by domestic
remedies. When I saw the case the patient was so weak and the slough so
large that I made no attempt at excision.” Her husband states that the de­
ceased had been a cigarm aker fo r a few years before her marriage.
No. 10, o f W ilmington, Del., died at the age o f 17 on June 4, 1910, o f
“ anthrax.” He was employed at $1.75 a day by a large m orocco firm and came
in contact w ith goat skins imported from South Am erica and from China.
The skins, according to the physician, were washed, but not disinfected, before
the boy handled them ; hot water, gloves, nailbrushes, and disinfectants were
provided for the workers. Bloodstained materials were eliminated “ as far
as possible,” but there was no special ventilation. The illness lasted fou r days.
“ W hen he sent for me,” declares the physician, “ I found the pustule on his
right chest, which, with the history o f his w orking in the m orocco factory, I
decided was probably anthrax. A slide confirmed it.” That is, anthrax bacilli
were found by m icroscopic examination. “ The course was very rapid,” con­
tinues the medical man, “ the people poor and could not afford serum treat­
ment, and he died. I cut out the pustule, but it did him no good.” No in­
demnity was received by the fam ily fo r the boy’s death.
No. 11, o f Latrobe, Pa., died at the age o f 34 on June 29, 1910, o f “ a n th ra x ;
septic intoxication.” H e was a laborer in a paper mill, his duties, according to
one who w as connected wT the mill at the time, being to unload baled rags from
ith
cars and to truck them into the storage sheds and to the cutting room, where
the rag cutters would cut the bales open and feed the rags into the cutting ma­
chines. The rags w ere principally cotton, coming in the main from “ all parts o f
the United States and Canada,” but occasionally as many as “ 50 cars o f foreign
rags ” would arrive at one time from England, Germany, France, Ireland, and
Spain. The rags w ere “ never treated with any disinfectant ” or cleaned. This
man’s w ork was done in the open air, on a platform which wT “ cleaned as
as
often as needed.” No hot water, gloves, nailbrushes, or disinfectants were pro­
vided ; in fact, says the inform ant, “ there has never been any precaution taken
in regard to the prevention o f disease.” The man went for treatment to a hos­
pital in Greensburg, Pa. The physician in charge o f the case states that the
clinical symptoms were so typical that he holds the case was one o f anthrax.
“ Tw o o f my colleagues who saw the case with me are o f the same opinion.
The man had a virulent infection above the ankle. There was at this point a
circular area, probably 2 inches in diameter, much reddened and elevated, with
a rather clear serous and somewhat depressed center. There was a marked
lymphangitis extending up the leg and thigh. The man was profoundly toxic
and had a high temperature range. W hen the diagnosis was made, which was
very soon after his admission to the hospital, he was removed to a tent which I
had erected in the yard, and there he died during the night follow ing admission.”
The duration o f the illness w as 10 days. Antianthrax serum was not available
for injection.




68

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

No. 12, o f Howe, Pa., died at the age o f 52 on July 19, 1910, o f “ an th ra x ;
skinning a cow dead with th e disease.” The man’s occupation is given merely
as “ laborer.” Illness lasted five days.
No. 13, o f Philadelphia, Pa., died at the age o f 60 on August 8, 1910, o f
“ a n th r a x ; bronchitis.” The disease lasted eight days. The patient was a
widow. No occupation is given on the death certificate.
No. 14, o f South Hadley, Mass., died at the age o f 15, on August 20, 1910,
o f “ general sep sis; anthrax.” According to the physician, he was employed at
$1.35 a day as bleach boy in the rag room o f a paper mill, but some time after
the occurrence the superintendent o f the mill is reported to have asserted that,
w hile the boy “ had access to the rag room and was probably there, he was not
supposed to be there.” The physician states that, although the rags used were
imported from France and Italy, they were “ all new clippings.” The physician’s
story indicates infection through a scratched arm. “ On Saturday night, August
13,” he says, “ patient slept out o f doors in a tent.” The next m orning he
“ noticed an ‘ insect bite ’ on middle o f left forearm w hich was swollen and
extrem ely itchy.” On M onday he returned from w ork “ in the middle o f the
forenoon, feeling sick. H ad a chill, nausea, and vom iting.” The physician saw
the patient first on W ednesday afternoon. H e “ had some fever and increased
pulse rate.” On the left forearm was a small localized swelling that looked like
a b o il; “ rest o f arm was normal, but left axillary glands and the whole left
chest w all was swollen. Patient had an' extremely septic look.” Under local
treatment and catharsis the patient apparently im proved fo r one day, but
Friday morning he was worse. The swelling was opened, and a very small
amount o f pus obtained. “ Friday night patient was very restless and looked
very sick. Tem perature and pulse w ere both high, and patient was vomiting.
Saturday morning patient was in a state o f collapse— subnormal temperature,
and radial pulse absent until stimulated with strychnia and camphor. Skin was
a dark livid red, cold, and covered w ith sweat. W as still vom iting and passing
black urine. It was not until now that I suspected anthrax.” The patient was
removed to a hospital in Holyoke, Mass., and a consultant called. “ Excised
localized area (about 2 inches in diam eter) and swabbed surface w ith pure
carbolic acid follow ed w ith alcohol. Swelling involved only the skin and sub­
cutaneous tissue. Patient died Saturday night.” The excised specimen was sent
to H arvard for diagnosis, and the report was anthrax.
No. 15, o f Maple H ill, Kans., died at the age o f 46 on October 2, 1910, o f
“ anthrax.” H e was a ranch foreman, and according to the physician’s state­
ment “ infection was through the skin in the forearm ,” where the man “ had
a little abrasion.” Three or fouV days before the disease broke out he “ helped
to skin and take care o f a dead cow ,” and it is supposed that he “ got the
infection at that time.” Death occurred in a hospital at La Junta, Colo.,
after five days’ illness, the disease taking the form o f “ malignant anthrax
edema.”
No. 16, o f Fairport, Ohio, died at the age o f 4 months 11 days on October
13, 1910, o f “ cramps— disease o f b o w e l; anthrax.” H ow this infant girl con­
tracted the disease the physician was unable to state.
No. 17, o f Baltimore, Md., died at the age o f 62 on Decem ber 2, 1910, o f
“ tox em ia ; anthrax.” He was employed at m ixing animal hair in machines,
preparatory to spinning. Illness was fatal after tw o days.
No. 18, o f Pomona, Cal., a retired farmer, died at the age o f 72 on December
8, 1910, o f “ a n th ra x ; senility,” according to the official death certificate.
No. 19, o f Newcastle, Pa., died at the age o f 78 on Decem ber 19, 1910, o f
“ a n th ra x ; exhaustion follow ing the disease.”
The deceased wT
as a baker,
and death occurred in a hospital after an illness o f one month’s duration.




AN TH RAX AS A N OCCUPATIONAL DISEASE.

69

No. 20, o f Breesport, N. Y., died at the age o f 46 on December 22, 1910,
o f “ anthrax, external, and general toxem ia.” H e was employed by a leather
company and handled hides, which the physician thinks were imported from
Australia. For the purpose o f treatment he was taken to Elmira, N. Y.
“ The local lesion,” says the doctor, “ was single and situated under the
low er jaw , about over the subm axillary gland. Undoubtedly infection gained
access through abrasion o f the skin at that point. H e rapidly became toxic
and unconscious and died within a few days from onset o f constitutional
symptoms. The local symptoms were first papular, then rapidly vesicular,
w ith an area o f cellulitis, and soon local gangrene.”
No. 21, o f Fresno, Cal., died at the age o f 52, on December 28, 1910, o f
“ anthrax follow ed by septic abscesses and pyemia.” H is occupation is given
as barber.
No. 22, o f Kittery, Me., died at the age o f 24, on December 29, 1910, o f “ septi­
cemia with malignant pustule.” He was a farmer, but the mode o f infection
could not be ascertained. The physician states that he displayed “ all the
typical clinical symptoms.” Death occurred after three days’ illness.
No. 23, o f Canastota, N. Y., died at the age o f 75, on January 27, 1911, o f
* an em ia; malignant pustule, right cheek.”
*
For much o f his life he had
worked as a cigar maker, but at the time o f his death had retired. Anti­
anthrax serum was not available.
No. 24, o f W aterford, Vt., died at the age o f 29, on February 28, 1911, o f
“ anthrax.” He did farm w ork about the neighborhood. A ccording to the phy­
sician, eight days before the man’s, death “ malignant pustule ” appeared in
the form o f “ pimple on face,” contracted by “ contagion from a sick cow .”
Curative serum was not available. There w ere no dependents.
No. 25, o f Harrison, Ind., died at the age o f 62, on April 28,1911, o f “ a n th ra x ;
septicemia.” His occupation is given as “ laborer.” Illness lasted, according
to the official death certificate, 21 days.
No. 26, o f Youngsville, La., died at the age o f 84, on April 28, 1911, o f
“ anthrax.” Deceased was a farmer. The record at the New Orleans hospital
to which he was sent furnishes these d a ta : “ Patient admitted to ward in
delirious state. W as unable to give coherent account o f illness. Friend, who
accompanied him to hospital, said that eight days prior to admission a small
sore like a boil appeared on bridge o f nose (this told him by patient’s w ife ).
The inflammation process spread rapidly and involved the skin o f forehead and
both eyelids, together with some o f the skin covering cheeks, in a gangrenous
process with necrosis and sloughing pustules here and there. Patient gradu­
ally grew w orse and died.” The eyes were “ closed by exudate from skin
lesion,” and “ punched-out ulcers with undermined edges ” were found on nose
and forehead. Anthrax bacilli were found. The patient hacl skinned a dead
cow some time before he became ill.
No. 27, o f W indham County, Conn., died at the age o f 72, on May 7, 1911, of
“ anthrax.” He was a self-employing tailor, and was partially supported by
an Army pension o f about $12 a month. His w ork consisted o f “ mending and
pressing old clothes,” states the physician. No antianthrax serum was avail­
able.
No. 28, o f New Britain, Conn., died at the age o f 52, on May 16, 1911;, o f
“ anthrax (m alignant pustule) ; septicemia.”
Her occupation is given as
housekeeper.
No. 29, o f Lynn, Mass., died at the age o f 38, on May 30, 1911, o f “ an th ra x ;
pulmonary tuberculosis.” H is occupation is given only as laborer. From the
hospital record it is learned that the patient went to the accident room “ with




70

B U L L E T IN OF T H E B U BEA U OF LABOR STATISTICS.

a small red spot on right cheek w hich he had had for tw o days.” There w as
also small swelling and redness around the spot. A “ slide was taken and
anthrax bacilli found.”
The patient, however, refused treatment and went
home, saying he would return in an hour. He did not go back until the follow ­
ing morning, when the spot had “ increased in size, swelling greatly in­
creased, and some edema.” Excision was then perform ed under ether, the
wound cauterized w ith carbolic acid, and corrosive poultices applied. The
man died on the fourth day after first applying at the hospital.
No. 30, o f Cleveland, Ohio, died at the age o f 40, on June 21, 1911, o f
“ malignant pustule; edema o f glottis.” H e was a traveling musician, “ w ith
a circus ” at the time o f infection, the physician is sure. W hile in a Pennsyl­
vania city he “ had a small infection on upper lip w hich he squeezed; follow in g
this the infection rapidly involved the whole upper lip, and he w as advised to
hurry home.” W hen called the physician “ recognized a very severe infection
with rapidly extending edema involving cheek and eye, temperature 105°,
w ith extrem ely rapid pulse.” Treatm ent consisted in local injections o f car­
bolic acid, ichthyol applications to his face, which w as edematous, w ith tem ­
perature baths and supportive treatm en t; medication mostly by hypodermic in­
jection. “ A strong attempt w as made to get anthrax vaccine, locally and
by telegraph.” One firm sent a supply through a local representative, “ but
patient died before application could be made.” The history o f the patient’s
“ traveling with the circus, his fondness for horses (by his ow n statem ent), the
initial lesion w ith extremely rapid progress o f disease, characteristic pustule,
gangrenous, vicious appearing ulcer, high temperature, and rapid disinte­
gration,” are considered by the physician convincing evidence o f anthrax.
No. 31, o f Monterey, Cal., died at the age o f 38, on July 10, 1911, o f “ an­
thrax ; acute urem ia.” The statement o f occupation is merely “ laborer.”
No. 32, o f Dubois, Pa., died at the age o f 38, on July 28, 1911, o f “ a n th ra x ;
anthrax edema.” Under the head o f occupation the death certificate says,
“ None.”
No. 33, o f Bakersfield, Cal., died at the age o f 42, on October 16, 1911, o f
“ anthrax.” The woman lived on a farm 16 miles from town. A pustule broke
out on her neck, but she paid little attention to it for 10 days, when she called
a physician, who pronounced it anthrax. “ It seems,” says the m edical man,
“ a sheep had died in the neighborhood, and as there w as an abundance o f flies
in the house there is no doubt that the infection was carried by the flies.”
Death occurred on the fifth day o f treatment. There were two dependents.
No. 34, o f Philadelphia, Pa., died at the age o f 38, on November 7, 1911, o f
“ an th ra x ; due to bacillus anthracis.” H is occupation is given as laborer.
No. 35, o f W ilmington, Del., died at the age o f 48, on November 20, 1911, o f
“ anthrax.” For tw o years previously he had been employed as an assorter o f
hides in a m orocco wT
orks, at $1.20 a day. The hides w ere im ported in a raw
state, and, according to the physician, w ere dom estic cleaned, but the cleanli­
ness o f the w orkroom was “ not what it should be ” and no gloves or nail­
brushes w^ere provided. The patient “ showed all the symptoms o f anthrax ” ;
no test for bacteria was made. Antianthrax serum w as injected, but “ too
late.” The w ife and fou r dependent children received no indemnity beyond
funeral expenses.
No. 36, o f New Orleans, La., died at the age o f 25, on December 27, 1911, o f
“ anthrax (carbuncle) ; malignant pustule.” H e was a salesman for an elec­
trical supply house. The attack lasted 10 days, appearing first, the hospital
physician says, as “ infection on upper lip, right side.” It then “ spread to nose
and face o f same s id e ; subsided after drainage and cauterization, follow ed by




A N T H R A X AS A N OCCU PATIO N AL DISEASE.

71

ichthyol dressing.” The final symptoms w ere “ rapid invasion o f other side o f
face, neck, chest, pharynx, etc.” Serum treatment was not utilized.
No. 37, o f Logan County, Ky., died at the age o f 51, on February 3, 1912, o f
“ malignant p u stu le; heart paralysis.” The wom an’s occupation is not given
on the official death blank.
No. 38, o f Philadelphia, Pa., died at the age o f 52, on February 6, 1912, o f
“ anthrax.” H e was a bristle comber and hair dyer, earning $1.50 a day, and
the m aterials he worked w ith came from Siberia. The illness lasted seven
days, but the doctor in the case states that the man “ had no physician until
the day before his death, when I was called in to attend him.” Six days
before he had noticed a pimple on the back o f his neck, but “ thought it o f
little consequence, w orking every day and using antiphlogistine, and in fact
intended to w ork the day before his death, but feeling very sick he sent for
me.” On exam ination the physician found on the back o f the patient’s neck
what at first seemed to be a carbuncle, but closer observation proved it was
not one. It was probably anthrax. The man was “ suffering severe pain and
had every evidence o f septic infection.” A few hours later excision was per­
form ed, which the patient said gave him great relief, “ as if a bar o f iron
had been removed from his neck.” The follow in g morning the physician “ w'as
called early and found him in extrem is.” Exam ination o f the specimen re­
moved showed anthrax.
No. 39, o f Mesopotamia, Ohio, died at the age o f 30, on February 13, 1912,
o f “ malignant pustule on right side o f fa c e ; abscess o f right kidney.” She
was a housewife, and the physician’s history shows a long period o f neglect o f
initial symptoms, “ as her people were strong Christian Scientists.” W hen a
m edical man was finally summoned he found a temperature o f “ about 103£%
pulse 110; patient went from bad to worse, until death finally ended the
scene.”
No. 40, o f Philadelphia, Pa., died at the age o f 47, on March 2, 1912, o f “ an­
thrax.”
Death occurred in a hospital. The man’s occupation is given as
hairdresser.
No. 41, o f W ilmington, Del., died at the age o f 19, on M arch 6, 1912, o f
“ anthrax.” H e was a m orocco worker, probably in the beam house. The
pustule appeared at the angle o f the jaw , and caused death by strangulation
in 48 hours.
No. 42, o f Toledo, Ohio, died at the age o f 57, on M arch 7, 1912, o f " ex­
haustion from chronic cystitis; blood poisoning; anthrax, malignant pustules
on leg and hand.” Nothing more definite than “ laborer ” is given as his
occupation. Death occurred in a hospital.
No. 43, o f Boston, Mass., died at the age o f 26, on M arch 9, 1912, o f “ sep­
ticem ia ; anthrax.” H e was a longshoreman, and for some time preceding
the date o f infection had been handling hides. The assistant superintendent
o f the hospital where he died on the day after admission and three days
after the beginning o f the attack states that the disease took the form o f a
“ small pimple, increasing until sides o f fa ce became sw ollen.” Exam ination
disclosed “ very numerous, very large bacilli— bacillus anthracis.” Treatm ent
w as by excision o f a “ w ide area about pustule.”
No. 44, o f New York, N. Y., died at the age o f 18 on June 2, 1912, o f “ malig­
nant pustule.” As far as the physician can recollect she was a school-teacher,
“ w ell developed, and in good physical condition, with a previous good history.”
She had been “ bit by a m osquito on the left cheek immediately below the
mouth.” On the follow ing day there w as observed a “ hard, tense sw elling,”
w hich in three or fou r days became “ much worse, much bigger, and exceedingly




72

BULLETIN OF TH E BUEEAU OF LABOR STATISTICS.

painfu l.” The mass w as opened, but as there was no improvement a second and
m ore extensive operation was perform ed the next morning. “ The patient w as
given appropriate vaccine treatment and everything was done for her, but she
died on the follow in g day.”
No. 45, o f Cincinnati, Ohio, died at the age o f 81 on July 23, 1912, o f “ anthrax
o r carbu n cle; septicemia and asthenia.” H e w as a retired pilot.
No. 46, o f Allegheny County, Pa., died at the age o f 55 on August 6, 1912, o f
“ anthrax.” The physician w ho made out the death certificate gave the occupa­
tion as foreman, but did not state in what kind o f an establishment he worked.
No. 47, o f Orange, N. J., died at the age o f 52, on September 13, 1912, o f
* inoculation by anthrax bacilli, causing general systemic poisoning.” H e was a
*
veterinary surgeon, and the medical record o f the case is so clear and striking
that it deserves to be quoted at length. W hen the patient first went to secure
m edical advice he had, reports the physician, “ a brownish spot at his left w rist
about the size o f a wart, and his left forearm w as swollen and edematous up to
the elbow. H e gave a history o f perform ing an autopsy on some cows about
12 days or more previous to seeing me, at w hich time he scratched his right
forefinger, but at once cauterized it. Nothing developed at this spot, but it
seems probable that he must have scratched him self on the left w rist at the
same time w ithout knowing it.” However, “ no symptoms o f any kind developed
for at least a week or more after the autopsy, and I think it was nearly tw o
weeks afterw ards that he first saw me. That m orning (September 9) he walked
into my office not looking sick and w ith a normal temperature and pulse, and his
forearm , though swollen and tense, was not angry looking.” The physician did
not know what to make o f his condition and immediately consulted tw o other
surgeons, who agreed w ith him that “ there was evidently some form o f infec­
tion, but none o f us knew what it was.” The patient was consequently taken to
a local hospital, where the pathologist took a culture from the “ w artlike
brownish spot at the w rist ” and reported next m orning that the culture
“ showed anthrax bacilli.” B y this time the swelling had “ extended 2 inches
above the elbow, and the spot at the w rist was as big as a quarter.” A physi­
cian from a large New Y ork hospital was called in consultation, who advised
that a few drops o f blood from the patient’s right ear be taken for examination.
This was done, “ and the slide showed anthrax bacilli, w hich indicated that
the bacilli were then in the general circulation.” The patient was again taken
to the local hospital, where that afternoon the New Y ork practitioner operated,
cutting out the original focus at the left w rist and making long incisions in the
arm and forearm. No pus was found, but the incisions w ere made to relieve
the tension and promote drainage. Though this operation w as perform ed w ithin
30 hours after the patient first presented him self for treatment, there was little
hope that it would save him, as the bacilli were all through the system, as
evidenced by the blood taken from the lobe o f the right ear. “ A Philadelphia
firm supplied through special messenger some anthrax serum made in Italy
(I believe), and this w as injected subcutaneously in large doses and repeated
at intervals. No instructions w ere given at first as to the method o f injection,
but latterly the serum w as injected directly into the veins as advised. In spite
o f all that was done, the patient gradually grew weaker and died quietly in
bed September 13, 1912.” The infected spot, adds the physician first consulted,
“ was unlike anything I have ever seen, and its extraordinary development
w ithin 24 hours was a sight not likely to be forgotten.”
No. 48, o f Stoddard County, Mo., died in Richland, Mo., at the age o f 59,
on October 14, 1912, o f “ anthrax.” Deceased was a farmer.
No. 49, o f Philadelphia, Pa., died at the age o f 34 on November 14, 1912, o f
“ anthrax.” The man was a laborer in a tannery and was admitted to a




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73

hospital on the fourth day o f the attack w ith “ anthrax lesion on neck.” He
died the follow ing day, leaving a widow.
No. 50, o f Peabody, Mass., died at the age o f 20, on November 18, 1912,
o f “ anthrax.” He had wrorked fo r about a year as a “ lumper ” in the color­
ing room in a m orocco and calfskin tannery, at $1.50 a day. According to
the hospital physician there was no special ventilation, but the workroom
was cleaned daily and hot w^ater was provided, also bichloride o f mercury as a
disinfectant. The disease took the form o f “ pustule, immense swelling.” The
pustule was cut out under local anesthetic, but death resulted suddenly from
“ em bolism ; blood vessels obstructed at site o f swelling.” From the indus­
trial accident board which administers the workm en’s compensation act in his
State it was learned that the pustule appeared on the right breast. On No­
vember 18 the man “ told the forem an when he went home at night that
he felt sick.” T w o days later he called a physician, and he was removed
to the hospital, where he died next morning. The man was married, and
his dependents were entitled to compensation, but lived in Europe and the
accident board was unable to locate them.
No. 51, o f St. Paul, Minn., died at the age o f 7, on November 20, 1912, o f
“ malignant pu stu le; blood poisoning.” The patient was a schoolgirl, and the
hospital authorities “ do not know how the disease was acquired.” Illness
lasted 14 d a y s ; antianthrax serum was not available.
No. 52, o f Graves County, Ky., died at the age o f 17, on December 4, 1912,
o f “ anthrax.” She was a housekeeper..
No. 53, o f Ballard County, Ky., died at the age o f 28, on December 23, 1912,
o f “ anthrax.” Her occupation is given as housewife.
No. 54, o f W ilmington, Del., died at the age o f 39, on January 19, 1913, o f
“ malignant pustule.” He was a stationary engineer in a large m orocco works.
No. 55, o f Philadelphia, Pa., died at the age o f 30, on January 23, 1913,
o f “ anthrax carbuncle o f neck.” He had w orked for only eight months at
the establishment where he contracted the fatal infection. The uncle w^ith
whom he lived states that he complained o f having a painful neck two days
before he called a physician, death occurring within the succeeding 24 hours.
The coroner’s inquest developed the follow ing in form ation : Deceased earned
$9 a week working as a laborer about a factory where “ curled hair was
handled.” Most o f the hair was imported from Russia, South Am erica, and
England. The firm stated that “ the usual precaution, by sterilizing the hair,
had been taken.” According to the coroner the firm “ supplies freely serum
imported from Italy,” but the man and his uncle “ apparently neglected avail­
able means o f treatment until too late.”
No. 56, o f Philadelphia, Pa., died at the age o f 55, on February 13, 1913, o f
“ anthrax.” He was a longshoreman, and seven days before death had loaded
hides and wool. First symptoms appeared seven days before death, in the
form o f “ pimple on right cheek.” On the day o f his death the patient was
ordered removed to a hospital, but died before the arrival o f the ambulance.
No. 57, o f Snohomish County, W ash., died at the age o f 58, on February 15,
1912, o f “ anthrax o f right hand.” She was a housewife.
No. 58, o f Gloversville, N. Y., died at the age o f 37, on M arch 1, 1913, o f
“ a n th ra x ; edema o f glottis.” Deceased was by trade a molder in a foundry,
but at the time o f contracting the disease had been employed about six months
in a leather-dressing establishment, liming skins and as general helper. Here,
according to the official occupational disease certificate, he “ had been helping
store away raw sheepskins, and picked small pimple on side o f neck.” The
ch ief symptoms wT
ere “ papilla (sm all) on left side o f neck over tonsil, chills.




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B U L L E T IN OF T H E BU B E A U OF LABOR STATISTICS.

moderate fever, 1 0 1 °-1 0 2 £ °; rapid pulse, 120-140; edematous swelling about
bead, neck, and chest.” The swelling was “ extrem ely rapid,” and the physician
elsewhere states that “ w ithin 24 hours it involved all the lymphatics o f the
neck and axilla.” A nthrax bacilli were found, but protective serum was not
available. Death occurred in fou r days. The sheepskins the man handled were
im ported from South Am erica and from A frica, and were frequently blood­
stained. Bloodstained m aterials were not eliminated, and were disinfected
only by the “ tanning solutions, lime, naphthalin, etc.” The cleanliness o f the
workroom is described as “ generally good ” by the physician, who further
states that hot w ater and disinfectants were furnished to the men, but no
gloves or nailbrushes. The w ife received a small indemnity.
No. 59, o f Brooklyn, N. Y., died at the age o f 46, on April 6, 1913, o f “ anthrax
o f the n eck ; fatty degeneration o f the heart.” Deceased w as a druggist, and
the physician who attended him was unable to determine the manner o f con­
tagion, but found anthrax bacilli and a true anthrax pustule. Treatm ent was
by “ antiseptic solution and antiseptic dressing.”
No. 60, o f Gardner, Mass., died at the age o f 33, on April 12, 1913, o f “ anthrax
infection o f face.” The man was a chair maker, and the physician states that
he “ could find no history o f contact w ith hides, leather, wool, or animal mat­
ter.” Nevertheless, anthrax bacilli w ere found. A pril 5 he squeezed a small
pimple on the right side o f his lip, and it immediately began to pain and swelL
H e was seen by a physician on April 7, when he had a “ congested pimple on
upper lip ” and “ temperature 104°.” Tw o days later he returned to the phy­
sician, w ith “ extreme inflammation o f side o f face, hardened area w ith car­
buncle appearance.” The follow in g day he was taken to a hospital, where he
died w ithin 48 hours. A ntianthrax serum w as not available,
No. 61, o f Cascade, Pa., died at the age o f 34, on May 2, 1913, o f “ anthrax.”
H e was a freight agent, and the physician states that “ infection was caused
by handling foreign hides.”
No. 62, o f Racine, Wis., died at the age o f 33, on M ay 5, 1913, o f “ malignant
pustule on face, also internal in m outh; edema o f glottis.” The woman was
a domestic servant.
No. 63, o f Philadelphia, Pa., died at the age o f 25, on May 9, 1913, o f “ an­
thrax.” The man was a haircloth maker. A ccording to a local newspaper he
felt ill after w orking over “ a bale o f hair from Siberia,” and went home.
“ Shortly afterw ards, apparently slightly better, he went fo r a w alk with his
w ife. Then came a sudden seizure which laid him unconscious in the street.”
A physician had him sent to a hospital, but “ he died on the w ay.” The paper
further states that the home was placed under quarantine.
The hospital
physician describes the symptoms as “ anthrax lesion o f left cheek.”
No. 64, o f W ilkes-Barre, Pa., died at the age o f 4 months, on M ay 28, 1913, o f
“ m alignant pustule.” The physician states that he was called in on May 24
and found the baby girl w ith a “ braw ny swelling about 1 inch in diameter
on the left side o f the face ju st above the lip.” Thinking it w as an insect bite
or an ordinary boil, he gave an antiseptic wash, but on calling the next day
he found the swelling “ had extended up to and was closing the eye, and skin
was o f a dark purple c o lo r ; fever quite pronounced.” The mother then stated
that she suspected the infant had been struck in the mouth w ith a fly swatter
by an older child. The abscess grew until it involved the w hole left side o f
the face, and then opened spontaneously. Large quantities o f pus were dis­
charged. The physician states positively that, “ while no m icroscopic exam i­
nation was made, the clinical symptoms clearly pointed to infection by anthrax
bacillus.”




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75

No, 65, o f Hennepin County, Minn., died at the age o f 16, on July 17, 1913, o f
anthrax. The boy w as the son o f a small berry farmer, and helped to cultivate
the berries and also to care for the cow and horse. The boy first complained
o f pain between the shoulder blades, and believed an insect had bitten him.
W hen he consulted a physician tw o or three days later the latter “ told him
it was a big carbuncle, as it had all that appearance,” and ordered 24 hours’
poulticing. “ When he came back,” says the doctor, “ I opened it, making a
cross incision to the bottom o f it, then w ith iodized phenol thoroughly cauter­
ized it out and dressed it w ith antiseptic gauze.” Three days afterw ards the
boy came back, “ having considerable temperature ” and “ more pain.” The
lesion w as curetted out, cauterized again, and then dressed twice daily, but
“ the malignancy kept spreading, delirium developed, as w ell as all the marked
symptoms o f blood poisoning.” A consultant w as called, w ho pronounced the
case anthrax. “ No matter how thoroughly the gangrenous parts were cleaned
out and strong antiseptics used, it kept extending. Temperature kept going
up until it reached 107°.” No laboratory examination was made, but the
attending practitioner states that the case “ was pronounced anthrax by tw o
physicians.”
No. 66, o f North Attleboro, Mass., died at the age o f 76, on July 20, 1913, o f
“ malignant pustule.” She had been acting as housekeeper and nurse for one
o f her daughters in a neighboring town who, according to her own fam ily
physician, died o f puerperal sepsis. W hile so engaged the woman “ scratched
her finger on a nail in cellar stairw ay,” and was seized with “ chills ” and
“ high fever.” Tw o days after returning to her own home the woman called
a physician, who found her arm swollen and “ o f dark purple,” fever 104°.
“ Next morning small pustules appeared on the whole extent o f limb, and
glands o f axilla appeared to be a whole solid mass.” General treatment was
administered to reduce the fever, three incisions were made the entire length
o f the arm, and a wet bichloride o f m ercury dressing (1 to 3,000) was applied.
Death occurred on the fourth day o f treatment. The physician states that in
his opinion “ infection was due to inoculation with bacillus anthracis.”
No. 67, o f W indsor Locks, Conn., died .at the age o f 49, on August 5, 1913, o f
“ malignant pu stu le; septicemia.” H e was a liverym an and the physician
states that “ it has never been cleared whether the case was anthrax from the
start, or if the patient was inoculated with the disease subsequently when, at
his request, the small pustule was opened with a penknife in the hands o f a
relative.” The knife had previously been used by the patient in incising what
he thought was an “ abscess ” on one o f his horses, but had disappeared before
the reporting physician took charge o f the case. The disease lasted five days,
appearing as “ pustule on upper lip, profound toxem ia from start.” B ac­
teriological examination was not complete, but antianthrax serum was injected.
L ocal treatment was by incision, drainage, and antiseptic applications.
No. 68, o f Brighton, Pa., died at the age o f 34, on August 13, 1913, o f “ an­
thrax.” She was a housewife, and the physician states that the “ symptoms
convinced him as to bacillus anthracis.”
No. 69, o f W ilmington, Del., died at the age o f 54, on August 23, 1913, o f
* anthrax.” He was employed by a large m orocco plant.
No. 70, o f Lincoln, Mo., died at the age o f 28 on September 8, 1913, o f “ an­
thrax ; m etastatic pneumonia.” Deceased was “ a robust, rugged young farm er.”
On September 3 the physician who was called to examine him found “ a large
vesicle at the seat o f infection ” on the septum o f the nose, and “ several small
vesicles on the external part o f the nose.” The disease had then been progress­
ing two or three days, and the whole nose was “ o f a very dark color and badly




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BULLETIN' OF THE BUEEAU OF LABOE STATISTICS.

swollen ” and one eye was “ swelled shut.” The nose was gangrenous in appear­
ance, “ and also in fact, as when I cut the nose with my knife he did not have
any painful sensations.” Temperature at the first visit was 99°, pulse 90, “ and
not a great deal o f constitutional disturbance.” On September 4 there was little
change, “ except that the gangrenous condition had extended to the left cheek.”
The follow in g day, however, “ he had a severe pain in the left side, temperature
101°, dullness on percussion over the low er lobe o f left lung, bloody expectora­
tion, crepitant rales on auscultation, and a further extension o f the gangrenous
condition o f the face.” On the 6th there was less pain in the side, but the
gangrenous condition on the face w^as “ still spreading.” By the 7th the right
lung had become involved, there was “ considerable difficulty o f breathing, pulse
rate greatly increased in freq u en cy ; gangrenous condition at this time extended
below the angle o f the ja w .” On September 8 all the symptoms had become more
severe, and when last seen by the physician he was “ going into a state o f
collapse and died in a short time. Anything I did for him did not check the
progress o f the disease in the least, and had he not been o f a very robust consti­
tution would have died sooner than he did.” None o f the pathological specimens
were examined m icroscopically, but from the clinical symptoms the doctor has
no doubt that he had “ to deal with a very severe case o f anthrax.”
; No. 71, o f Gates, N. Y., died at the age o f 16, on September 29, 1918, o f “ splenic
fe v e r ; malignant facial anthrax.” The physician states that the boy “ chored
around home,” and that the source o f the infection is unknown. “ Pustule
appeared on low er lip, spread rapidly over whole left side o f f a c e ; chills, enlarge­
ment o f spleen, high fever, gastroenteric hemorrhages and m eningitis; died
in coma.”
No. 72, o f Elyria, Ohio, died at the age o f 67, on October 7, 1918, o f “ an th ra x ;
chronic nephritis.” H e was a physician.
No. 73, o f Unity, Pa., died at the age o f 1, on October 22, 1913, o f “ cholera
infantum and anthrax.” The physician states that the child, a girl, was ill about
three weeks. H e did not think it necessary to make a m icroscopic examination,
but is certain case “ was due to inoculation w ith bacillus anthracis.” Protective
serum was not available. The fam ily, he declares, was “ very unclean, and child
could have contracted the disease by toying with a diseased dog or cat, or from
partaking o f milk or butter, or through the agency o f flies or insects, or by
inhaling dust containing the virus.”
No. 74, o f Elkland, Pa., died at the age o f 52, on October 23, 1913, o f
“ a n th ra x ; infection upon the neck.” H e handled hides in a tannery, re­
ceiving $2 a day. The hides were im ported from South Am erica and China.
Bloodstained m aterials were not elim inated at the plant, the physician says,
and he does not think disinfection was carried on or that gloves or nail­
brushes were furnished.
The man sought m edical assistance only when
it was “ too late for human aid.” H e was taken to Lycom ing County. Anti­
anthrax serum was obtained in Philadelphia and freely used, but the disease
had already progressed too far, and he died on the sixth day o f the attack.
The company paid the funeral expenses and offered the w idow $500 in settle­
ment, which she refused. The law yer in whose hands she put the case secured
a judgment for $300, out o f w hich he charged a $90 fee. Apparently the suit
dragged until the beginning o f 1916, for the w idow states that “ they are now
paying me $10 per month ” since January 1 o f that year.
No. 75, o f H anford, Cal., died at the age o f 33, on November 11, 1913, o f
“ anthrax.”
He was a ranch laborer, earning $2 a day. First symptoms
appeared on November 6, but a physician was not called until the 9th. At
that time, says the latter, “ the face was swollen on right side over antrum




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77

and was quite tender to pressure. Tenderness on canine and biscuspid teeth
was shown when pressure was made. Eyelid edematous and red. Diagnosis
at that time was made as abscess o f antrum, and operation fo r draining was
advised.” The same evening the floor o f the antrum was perforated under
ether “ and a dark, bloody discharge escaped.” The patient regained con­
sciousness, but the next morning the swelling had greatly increased on right
side, closing the eye and assuming a dark purplish hue. The left side o f the
face became involved. Bloody secretions drained from nose on right side and
from opening draining the antrum. “ A peculiar odor from the patient caused
me to associate it w ith the odor I had noted in a cow dying from anthrax.
Specimens taken from secretions o f nose and antrum each showed the anthrax
bacillus in large numbers. A t noon on the 10th the patient became uncon­
scious. Patient died at 3 o ’clock on the afternoon o f the 11th.” Death oc­
curred in a sanatorium.
No. 76, o f Boston, Mass., died at the age o f 23, on December 13, 1913, o f
“ a n th ra x ; toxem ia.”
Deceased was a longshoreman.
From the hospital
record it is learned that tw o weeks before admission he “ handled South Ameri­
can hides,” and three days before admission he 4 handled Am erican hides.”
4
Four days before he entered the hospital a “ pimple appeared on his right neck
below the angle o f the jaw . Several blebs appeared later around the pimple
which broke down. Pain and swelling with redness and induration follow ed.”
A t the time o f admission the patient presented “ a small brow n ulcer on right
side o f neck one-third inch in diameter, surrounded by a circle o f white blebs
hear by. Considerable edema o f whole right side o f neck extending as far
forw ard as point o f ja w ; temperature, 10 2°; w hite blood count, 32,400.” A
circular excision was made and swabbed out w ith iodin e; forced nourishment
and stimulants w^ere g iv e n ; corrosive 1/5,000 dressing every four hours.
Blood culture was positive fo r anthrax bacillus. “ Edema soon extended down
whole right side o f chest, turning a dusky red. Patient failed gradually since
operation,” though suffering little pain. Finally he “ became delirious and in a
few hours sank into coma and died.” The deceased left a dependent mother,
but indemnity, which under the M assachusetts workm en’s compensation law is
paid for cases o f anthrax, was refused in this case, because the insurance com­
pany contended that the disease was not contracted while the deceased was
in the employ o f their policyholder, but while working for another company.
No. 77, o f Winchester, Va., died at the age o f 46, on December 20, 1913, o f
“ blood poisoning, the result o f anthrax.” He was a barber.
No. 78, o f Union, N. Y., died at the age o f 56, on December 24, 1913, o f
“ anthrax infection.” The disease took the form o f “ anthrax edema ” ; it
“ developed on the f a c e ; advance was very rapid to extensive involvement o f
face, head, and neck ” ; diagnosis was made on the third day and was con­
firmed by the State laboratories. The deceased was a farmer, and, according
to the physician, “ was in the habit o f buying up old and poorly nourished cat­
tle, butchering them, and selling them where he could. H e certainly handled
diseased meat.” A t the time o f his death he was awaiting trial for selling
tuberculous meat. “ The hired man,” continues the doctor, “ says he has gone
home at night leaving a very sick cow in the stable and found in the morning
a beef dressed and the sick animal missing. No questions were asked or
answered in regard to it.” It therefore seems to the physician “ likely that
infection took place during, or as a result of, his occupation as a handler o f
dom estic beef, and that often diseased.”
No. 79, o f South W indsor, Conn., died at the age o f 14, on January 16, 1914,
o f “ anthrax or malignant pu stu le; toxem ia.” The girl had no occupation.
The illness lasted 10 days.




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B U L L E T IN OF T H E B U REA U OF LABOR STATISTICS.

No. 80, o f Camden, N. J., died at the age o f 47, on January 29, 1914, o f
“ anthrax (m alignant p u stu le).” H e had been employed fo r eight months
as a checker and receiver o f horse hides im ported from Russia in an estab­
lishment where leather w as tanned and finished. D iagnosis w as made on the
second day o f the illness. T h e pustule w as located under the right ear. The
physician also found edema o f upper chest, rapid pulse, cold extrem ities, no
pain, and no com plicating conditions. Serum treatment was used, but with
no improvement. The illness lasted fou r days. Previous to entering the occu­
pation w hich caused his death he had been an undertaker.
No. 81, o f Frem ont, Ohio, died at the age o f 52, on March 9, 1914, o f “ rheu­
matism and an th rax; pericarditis.” According to the official death certificate
the illness lasted three months. The occupation o f the patient is not stated.
No. 82, o f Philadelphia, Pa., died at the age o f 30, on M arch 15, 1914, o f
“ anthrax.” “ Anthrax bacillus was proved by finding the organism in the
discharge from his cervical lesion.” The man was colored and w orked as a
stevedore, and three days before his death he had been “ unloading a cargo
o f hair from China.” The physician who examined him at the hospital “ found
a diffuse sw elling o f the right cervical region, w ith evidence o f a small pustule
which had ruptured and wT rather inconspicuous because o f the dark surface
as
o f the skin. The case w as not diagnosed at the time as one o f malignant
pustule, and an incision for the purpose o f drainage w as made in the neck.”
The patient came to the hospital next day, and a number o f incisions were
made on his neck fo r the purpose o f relieving his respiratory difficulty. “ H e
grew progressively worse, and died in the hospital ward 60 hours from
the time he applied fo r treatment. Our cultures showed the anthrax bacillus
in both cultures.”
No. 83, o f Pleasant Prairie, W is., died at the age o f 55, on M arch 20,
1914, o f “ anthrax, general infection.” H e w as a farm er. Physician states
that the man opened a cow to ascertain the cause o f its death and found
in its abdomen black spots, which he dissected. The “ pubic region and limbs ”
w ere affected. Exam ination showed “ various necrotic areas which rapidly
broke down. Scrotum very much enlarged and necrotic.” Patient w as de­
lirious fo r tw o days. The illness lasted seven days.
No. 84, o f Calexico, Cal., died at the age o f 70, on April 6, 1914, o f “ sep­
ticem ia, almost certainly due to anthrax in a c o w ; died o f it a few days
ago.” The illness lasted five days. The patient w as a housewife.
No. 85, o f Philadelphia, Pa., died at the age o f 38, on April 6, 1914, o f “ an­
th rax.” She w as a housewife.
No. 86, o f N orfolk, Va., died at the age o f 54, on April 11, 1914, o f “ anthrax
(m alignant e d e m a ); toxem ia.” Illness lasted five days.
No. 87, o f Philadelphia, Pa., died at the age o f 60, on May 6, 1914, o f
“ anthrax.” H e was a skin washer in a leather factory. Illness lasted fou r
days. T h e physician at the hospital w here he w as admitted on the third day
o f the disease describes the attack as “ anthrax lesion on le ft side o f face.”
No. 88, o f New Orleans, La., died at the age o f 3 months, on M ay 29, 1914, o f
“ anthrax at base o f sp ine; scrofula.” H e w as ill one month.
No. 89, o f Philadelphia, Pa., died at the age o f 35, on June 17, 1914, o f
“ anthrax.” The patient wT c o lo re d ; he w orked as a longshoreman, and three
as
days previous to admission to the hospital where he died he w as unloading
hides. “ Tw o days after that,” w rites the physician, “ a pim ple on the face
began to swT
ell rapidly, causing little pain.
The sw elling progressed and
involved all the tissues o f the neck. Anthrax serum w as not used in the
treatment.”




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79

No. 90, o f Cincinnati, Ohio, died at the age o f 41, on August 8, 1914, o f
“ anthrax infection o f f a c e ; acute nephritis.” He was a tailor and presser.
He became sick on August 2 ; the first symptom “ appeared on the upper lip,
where a horsefly bit him while out in the country. Entire face swelled up and
was somewhat red and edematous. Both eyes w ere closed from extensive
swelling.”
No. 91, o f Lewiston, Me., died at the age o f 45 years, on August 19, 1914, o f
“ endocarditis, with chronic rheumatism and anthrax.”
H is occupation was
given by the official certificate as laborer, and the physician states that his
average earnings wrere $1.75 a day. The attack is described as “ cauliflower
on the back o f the neck.” The treatment given w as “ cruciform opening and
burning wT
ith cautery.” Serum was not used.
No. 92, o f Hollidaysburg, Pa., died at the age o f 18 years, on September 10,
1914, o f “ malignant pustule.” She had no occupation.
No. 93, o f Wilmington, Del., died at the age o f 29, on October 10, 1914, o f
“ a n th ra x ; edema o f larynx.” H e was a m orocco worker.
No. 94, o f Brooklyn, N. Y., died at the age o f 56, on November 25, 1914, o f
“ a n th ra x ; infection bacillus anthracis.” The official death certificate desig­
nated him merely as “ laborer,” but from other sources it was learned that he
worked in a tannery. “ Tw o days before admission to the hospital patient
noticed a small pimple on n e c k ; he said he pinched i t ; from that time on the
neck became more and more swollen. A t first there was little pain, but a diffi­
culty in breathing developed ju st before admission.” In the hospital “ excision
o f pustule and incisions o f indurated area ” were made. The patient died four
days later. Anthrax bacilli w ere “ recovered from all organs.”
No. 95, o f Smithson, Pa., died at the age o f 42, on December 8, 1914, o f
“ anthrax.”
He was a liveryman. H e was two days at a hospital in
M cKeesport, Pa.
No. 96, o f Lincoln, Nebr., died at the age o f 39, on December 8, 1914, o f
“ septic infection due to anthrax bacillus.” H er occupation was given as house­
w ife. She was ill one month.
No. 97, o f Camden, N. J., died at the age o f 53, on December 31, 1914, o f
“ anthrax.” He was a laborer in a m orocco factory. The physician, when
called in, found the patient dying. Exam ination disclosed “ external anthrax,
malignant pustule, high fever, edema o f glands and surrounding parts.” The
illness lasted five days.
No. 98, o f Fort Morgan, Colo., died at the age o f 1, on M arch 29, 1915, o f “ an­
thrax ; measles.” The child, according to the physician, was scratched on the leg
by the teeth o f a small dog with which he was playing. The parents attached no
im portance to the incident, and did not even wash or cauterize the scratch. T w o
or three days later, the child was taken, with a badly swollen leg, to the phy­
sician, who discovered that a calf had died o f anthrax on the farm and that
the dog had been getting his meals from the carcass, which had not been
burned or buried. “ The child w as very ill when I saw it first. No serum was
available when I recognized the cause o f infection. The temperature was
high. The secretion from the limb was bloody. No pus. The swelling con­
tinued to increase and extended upward to the abdomen. The leg was kept in
a wet dressing o f bichloride, w hile stimulants were given internally.” A cul­
ture in blood serum was made and “ a pure culture o f anthrax ” resulted.
The child was ill two weeks.
No. 99, o f Dos Palos, Cal., died at the age o f 25, on April 3, 1915, o f “ a n th ra x ;
due to bacillus anthracis.” H e was a farm laborer, and at the time o f the at­
tack he handled cattle and cattle hides o f local origin. “ Patient was taken sick




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about March 21, 1915,” writes the physician o f a hospital in Fresno where the
man was taken for treatment. “ A t this time he was treated by a doctor who
made the diagnosis o f pleurisy with rheumatism. At the onset he had severe
pain in the left side w ith several chills. This was shortly follow ed by a
sw elling o f the right ankle, which was quite tender and painful. Patient
came under our care on M arch 28, 1915.” In the hospital his case was diagnosed
as “ pulmonary anthrax, with general blood infection.” Local treatment was
applied to the pustules, which were situated on the low er eyelid and on the
anterior surface o f the thigh, and smears from both lesions showed anthrax
bacilli. On April 1, 40 cubic centimeters o f antianthrax serum were injected
intravenously; on the follow ing d<iy a dose o f 60 cubic centimeters w as given.
“ This is all the antianthrax serum we w ere able to secure on the coast,”
writes the hospital physician. The patient died on the thirteenth day o f his
illness.
No. 100, o f H artford City, Ind., died at the age o f 69, on April 4, 1915, o f
“ malignant anthrax.” H e was a merchant. The physician in charge stated
that this was a case o f “ infectious febrile disease due to the inoculation into
the hand o f the anthrax bacillus. Death being due to obstruction o f circula­
tion by these b a c illi; much subcutaneous edema near the inoculation wound,
and also m etastatic lesions.”
No. 101, o f W illiam sport, Pa., died at the age o f 53, on A pril 25, 1915, o f
“ anthrax causing edema o f la r y n x ; facial anthrax.” Occupation is given
merely as “ laborer.”
No. 102, o f Coudersport, Pa., died at the age o f 31, on May 12, 1915, o f “ in­
ternal a n th r a x ; typical case true anthrax.” H is occupation is given as laborer.
No. 103, o f Coudersport, Pa., died .at the age o f 29, on May 18, 1915, o f “ septic
in fe ctio n ; typical case true anthrax.” F or several years he had been employed at about $1.60 per day as a laborer in a tannery, where sole leather was
made. H e came in contact wT
ith imported dried hides.
According to the
physician in charge o f the case, no sanitary precautions were taken. Not all
the hides were disin fected; there w as no special ventilation; the w orkroom s
were very dirty. The disease took the form o f a pustule on the neck. A t the
hospital, where the patient wT taken, excision wT perform ed and carbolic acid
as
as
was injected around the affected area. Serum was not available; the illness
lasted six days.
No. 104, o f Nunda, N. Y., died at the age o f 14, on May 24, 1915, o f “ septi­
cemia ; anthrax o f back.” Physician says “ all symptoms point to true an­
thrax.” The disease was not suspected until three days before the boy’s death,
when diagnosis was made. The patient had high fever and delirium, and the
disease developed rapidly. The boy was attending school and choring about
the house.
No. 105, o f Endicott, N. Y., died at the age o f 22, on June 1, 1915, o f “ septi­
cemia ; anthrax.” The deceased was employed in a leather factory unloading
dry South Am erican and Chinese hides. They w^ere said to have been disin­
fected. Exam ination showed “ infection on arm and neck, and swollen chest.”
The hospital physician states that he “ injected with 12 per cent carbolic acid
and removed infected area.” No serum was given. The illness lasted tw o days.
“ Positive diagnosis was made after death by bacteriological test o f blood and
tissue o f arm.”
No. 106, o f Thompsonville, Conn., died at the age o f 35, on June 7, 1^15, o f
“ anthrax in fe ctio n ; genuine a n th ra x ; from initial ulceration on neck.” The
anthrax organism was “ diagnosed in smear and culture.” H e was employed in
a carpet factory. The physician at the H artford hospital, where the patient




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81

was taken, states that there was a “ pustule on anterior neck, and edema and
cyanosis o f anterior chest.” Serum was not available. The illness lasted six
days.
No. 107, o f Brooklyn, N. Y., died at the age o f 6, on June 29, 1915, o f “ general
asthenia from anthrax infection o f nose.” “ An infectious febrile disease w ith
local symptoms,” says the physician, “ m anifested itself in nose and its accessory
and other sin u ses; the discharge showed a bacillus having all the characteristics
o f the bacillus anthracis.” The child’s illness lasted 15 days.
No. 108, o f Charlestown, Mass., died at the age o f 50, on July 4, 1915, o f
“ anthrax.” Autopsy showed that “ he suffered from anthrax septicemia, with
associated leptomeningitis and hydrothorax.” H e was a longshoreman. “ In­
vestigation brought out,” states the physician o f the Boston hospital where the
man died, “ that on May 25, 1915, he worked in the hold o f a vessel laden with
dried blood, ground bones, and phosphate, and subsequently to that date assisted
in the discharging o f dried hides.”
No. 109, o f New Orleans, La., died at the age o f 23, on July 8, 1915, o f
“ acute n eph ritis; edema o f lu n g s; bacillus a n th racis; septicemia.” H e was a
laborer.
No. 110, o f Boston, Mass., died at the age o f 38, on July 8, 1915, o f “ a n th ra x ;
neck infection w ith bacillus anthracis.” H e was unloading dry hides at the
wharves. The physician at the hospital where the patient was admitted on the
day before his death describes his disease as “ septicemia w ith brawny swelling
of right face and neck and bulla form ation. No local carbuncle. Blood cultures
were positive.”
No. I l l , o f New Y ork City, died at the age o f 34, on July 29,1915, o f “ anthrax
infection o f neck.” H e was a weigher in the United States customhouse and
handled skins and hides from South America. H is duty was to tear open bales
to inspect and weigh their contents. Not all the m aterials he handled were
disinfected, and no care was taken to prevent danger. H e had been in the
w ork since 1908 and w as earning on the average $4.50 a day. The physician
to whom he applied fo r treatment perform ed “ excision o f lesion and drainage.”
No serum was used. The illness lasted five days. A portion o f the excised
tissue was sent fo r exam ination to the research laboratory o f the New York
City Departm ent o f Health, which rep orted : “ M icroscopic exam ination o f gland
removed from neck shows anthrax bacillus in culture and liver o f dead injected
mice.” The physician considered the case particularly pathetic because the
w idow was “ left without means and w ith three small children,” and since the
Federal W orkm en’s Compensation A ct o f 1908 dcres not cover the employees o f
the customhouse, the physician’s efforts to obtain a pension from the United
States Government fo r the w idow w ere unsuccessful, as “ there appears to be no
provision for such cases. It would seem that the Government should make some
provision for the ones left dependent through its employment o f workers at
occupations likely to cause their death.” A special bill for the relief o f this
fam ily was finally introduced in Congress, almost a year after the man’ s death,
but up to the time this report was written the H ouse Committee on Claims, to
w hich the bill was referred, had taken no action on it.
No. 112, o f Bountiful, Utah, died at the age o f 65, on August 24, 1915, o f
“ anthrax.” Death occurred in the farm ers’ ward o f the county hospital at Salt
Lake City, after three days’ treatment. The man was a carpenter.
No. 113, o f Baltimore, Md., died at the age o f 20, on August 30, 1915, o f “ pus
tula maligna on under l i p ; p y em ia ; anthrax.” The victim had no em ploym ent;
she lived at home with her parents and at the time o f her illness was visiting
141633°— Bull. 267— 20-------6




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B U L L E T IN OF T H E B U REA U OF LABOR STATISTICS.

New York. The first symptoms appeared about August 18. The young woman
“ had a pimple on her low er lip and, as it annoyed her, she pricked it w ith a
needle. It steadily grew w orse,” and she went to a hospital across the street.
There she was treated as an outpatient fo r a few days. The diagnosis o f an­
thrax wT m ade on August 25, and then “ injections o f iodine and other germ i­
as
cides ” were made and 4 constitutional treatment internally ” w as given. Serum
4
was “ not obtainable. The pus filtration w as very rapid and spread to the
right cheek and neck alarm ingly.” The physician w as unable to find out to
what uses the needle had been put w ith w hich the patient pricked the pimple
on her lip.
No. 114, o f New London, Conn., died at the age o f 57, on September 3, 1915,
o f “ malignant p u stu le; convulsions.” H is occupation is given as printer.
No. 115, o f Brentw ood, N. Y., died at the age o f 23, on September 29, 1915,
o f “ malignant anthrax edema.” She w as a clerk in the post office. The hospital
physician w ho attended the case diagnosed it as “ infection w ith bacillus
anthracis, w hich bacillus w as recovered from the excised papule at the New
Y ork City research laboratory. The source o f this infection, which was on
the side o f the neck, w as not determined.” The physician states, however,
that the young woman had “ tried on clothing trimmed w ith fu r at various
department stores in New Y ork City.” The disease took the form o f malignant
edema, “ w ithout pustule except fleabitelike papule.” Curative serium w as se­
cured from Philadelphia, after unsuccessful efforts to obtain it in New York,
and injected both subcutaneously and intravenously. Supportive treatment was
also given, but death occurred on the sixth day.
No. 116, o f New Y ork City, died at the age o f 52, on October 7, 1915, o f
“ anthrax.” The first symptom w as an “ itching sensation on chest.” E xam ina­
tion by the hospital physician disclosed “ papule on chest, w ith spreading in­
flammation over left side o f body. Fever and prostration. Both m icroscopical
exam ination and autopsy proved case to be due to bacillus anthracis.” The
patient had been w orking fo r five years as a laborer and driver and during
the week before illness w as unloading hides from a vessel. H e w as ill four
d a y s; diagnosis w as made on the day preceding his death. No serum was
available.
No. 117, o f Madison, N. Y., died at the age o f 52, on October 12, 1915, o f
“ po?son from a n th ra x ; cardiac paralysis.” H is occupation is not given on
the official certificate. The physician stated that death w as due to “ true
an th rax; fever and involvem ent o f the glands.”
No. 118, o f Riverhead, N. Y., died at the age o f 71, on October 15, 1915, o f
“ anthrax.” The patient was a retired lawyer and did no w ork except caring
for his own home. The manner o f infection was a puzzle to the physicians, as
he came in contact neither with nondisinfected m aterial nor with animals. The
man w as never ill before. On October 8 he first noticed on his face a small
lump, w hich soon became a red itching spot. The disease spread rapidly over
his face, it reached the chin and attacked the glands o f the neck. On the fo l­
low ing day he was taken to the hospital and the disease w as diagnosed as
an th rax; ISO c.c. o f Eichorn’s serum were injected during the period o f three
days, but w ithout avail. Anthrax bacilli w ere demonstrated.
No. 119, o f Blue Earth County, Minn., died at the age o f 35, on October 22,
1915, o f “ external and internal anthrax.” The physician’s statement gives
“ diagnosis o f inoculation with bacillus anthracis.” The patient was a house­
wife, H er illness lasted 12 days.
No. 120, o f Bainbridge, N. Y., died at the age o f 24, on November 12, 1915, o f
“ septicem ia; probably anthrax bacillus.” The deceased w as helping on her




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83

father’s dairy farm doing housework and milking. T h e disease w as diagnosed
as- anthrax by tw o physicians who had seen cases before. The illness lasted
10 days. Serum was not available.
No. 121, o f New Y ork City, died at the age o f 17, on November 18, 1915, o f
“ anthrax.” The cause o f the death is further described by the hospital super­
intendent as “ infectious febrile disease due to inoculation w ith bacillus an­
thracis.” The patient w as a candy packer. On November 14 she was taken
ill. A physician was called, and found a small gray spot on her chest, which,
according to= the patient, h ad appeared: five days previously. W ithin the next
three days the spot became red and inflamed and her condition grew so alarm­
ing that she was sent to the hospital* where 40 c;c. o f serum wT
ere injected.
The patient died 12 hours later. The presence o f anthrax bacilli w as proved.
Some physicians believed that the patient became in fected from a neck piece
made o f cat’s fur. As a result official medical inspectors examined a large num­
ber o f fur-m aking shops, mostly on the low er East Side; where the victim
bought her fur. The theory was opposed, however, by another group o f official
medical men, who maintained that infection from cat’s fu r is exceptionally rare.
No. 122, o f Philadelphia, Pa., died at the age o f 69, on November 20, 1915, o f
“ septicemia due to malignant pustule on h ip ; cirrhosis o f liver.” The dura­
tion o f the anthrax attack is given as 1 month and 10 days, and the man’s
occupation is given on the death certificate as “ cake baker.”
No. 123, o f Johnson City,. N. Y., died at the age o f 49 on November 20> 1915,
of “ anthrax.” He was a laborer in a large tannery. H is w idow made a claim
for indemnity under the New Y ork workm en’s compensation law, and from
the decision o f tlie State industrial commission it appears that “ while being
shaved on November 16 *his neck was slightly cut w ith a razor. Shortly after
commencing w ork the follow in g morning his neck began to swell, anthrax germs
having presumably entered the cut.”
On that morning, the w idow states,
“ there was a little white spot in the middle o f the pimple which appeared to
be festered and. appeared as though there was pus in it. I took, a needle and
pricked it and lifted up the edge o f the white part, but no pus was discharged
but it bled a little.” N ext day the patient w as rem oved to a hospital where
he died two days later. Smears from the anthrax bacilli were found. The
industrial commission agreed that the cause o f death was anthrax and that it
was contracted from the hides among w hich the deceased was working.
Indemnity was, however, denied on the ground that the cut oil the neck
through w hich infection took place was not received in the course o f employ­
ment.
No. 124, o f Lewistown, Mont., died at the age o f 16, on November 21, 1915,
o f “ anthrax in fe ctio n ; septicemia.” H e was a farm hand.
No.. 125, o f Kings County, Cal., died at the age o f 56,. on November 26, 1915,
from “ anthrax on back o f n e c k ; exhaustion.” H e was first reported as a
painter but later as a laborer, not having any particular kind o f work.. H is
illness was stated by the hospital physician to be “ due to infection o f bacillus
anthracis producing carbuncle and general infection.” Stimulants w ere given
but serum was not available. H e w as ill tw o days, and died an hour after
arrival at the hospital.
No. 126j o f New Brunswick* N. J., died a t the age o f 25, on November 26,
1915, o f “ cellulitis o f n e c k ; sep sis; a n th ra x ; valvular heart disease.” De­
ceased was a laborer and w orked in a clay pit. The malady took the form
o f a large pustule on the neck, which, the physician reported was “ genuine
anthrax.” Anthrax bacilli w ere found. Serum wa& not ava ila b le; the illness
lasted three days.




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B ULLETIN OE TH E BUREAU OF LABOR STATISTICS.

No. 127, o f Chelsea, Mass., died at the age o f 40, on November 27, 1915,
o f “ a n th ra x ; malignant pustule.” H e was a freight handler at the wharves.
“ Autopsy showed that he died from anthrax septicemia, the principal ana­
tom ical lesions being pustule o f the cheek, focal necrosis with hemorrhage o f
the stomach, jejunum , and ileum ; hemorrhage o f the cervical and mesenteric
lymph nodes.”
No. 128, o f W inchester, Mass., died at the age o f 31, on November 27, 1915,
o f “ anthrax.” H e was employed in a tannery. A ccording to the physician
at the Boston hospital where the man died, it was a fairly typical lesion. A
crucial incision was made on the day o f admission. “ Autopsy showed that he
died from anthrax septicemia, the principal anatomical lesions being pustule
o f the upper arm (incised) ; enlargement w ith hemorrhage o f the axillary,
mesenteric, and aortic lymph n odes; enlargement and softening o f the spleen;
focal necrosis and hemorrhage o f the gastrointestinal tract.”
No. 129, o f New Y ork City, died at the age o f 25, on November 28, 1915, o f
“ malignant a n th ra x ; edema.” H e w as a m edical student.
No. 130, o f W illington, Conn., died at the age o f 9, on December 5, 1915,
of “ malignant pustule; general septicemia. No bacteriological culture was
taken, but according to the physician the case presented a “ perfect clinical
picture o f true anthrax.” The g irl’s occupation is given as “ at school.”
No. 131, o f Brooklyn, N. Y., died at the age o f 45, on Decem ber 18, 1915,
o f “ a n th ra x ; edema o f g lo ttis ; acute cardiac dilatation.” H e was a laborer
and handled hides at the docks. On admission to-the hospital “ he showed tw o
typical punched-out ulcers w ith escharotic bases, small vesicles surrounding
each lesion with marked inflam matory areolae. There was intense swelling
and edema o f the whole right side o f neck extending down to chest. Anxious
face, sweating o f head, pulse barely perceptible, marked difficulty in respira­
tion and dilated heart. * * * Patient complained o f intense general abdbminal pain (fo r w hich no reason could be discovered on ante mortem ex­
am in ation).” “ Smears from lesions o f neck showed anthrax bacilli.” Serum
“ could not be obtained in time.” H e died in 15£ hours after admission to the
hospital, the illness lasting altogether three days.
No. 132, o f St. Paul, Minn., died at the age o f 60, on Decem ber 27, 1915,
o f “ malignant anthrax (carbuncle) on back o f neck.” H e wT
as a farmer,
and also occasionally did carpentering. W hen the physician was called he
found a “ carbuncle on the posterior region o f neck.” The neck w as badly
sw ollen ; an “ incision w as made.” The wound w as dressed every day. Food
and remedies to sustain strength w ere given and the patient w as kept in
bed. H e w as under the doctor’s care only three days.
No. 133, o f Niles, Mich., died at the age o f 60, on January 17, 1916, o f
“ an th rax; sepsis.” T h e.disease manifested itself in a “ small p u stu le” with
rapid swelling, on the right side o f the neck. A physician to whom he first
went poulticed him w ith antiphlogistine. “ May God have mercy on that doc­
tor’s soul,” w rites the m edical man w ho attended him when he died tw^o weeks
later. When the second doctor took charge o f the case the patient w as already
very weak. Deceased w as a w idower, living alone in a cheap boarding house,
where little inform ation about him could be obtained. H e had been engaged
at loading and unloading raw hides, both domestic and some im ported from
Brazil and Argentina. No m icroscopical exam ination was made, but “ the
clinical appearance, together with the history o f the case and the experience
I have had with the disease in other countries, was satisfactory to make the
diagnosis,” w rites the doctor who made out the death certificate.




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85

No. 134, o f Columbia County, W ash., the owner and manager o f a large sheep
ranch, died at the age o f 54 on January 29, 1916, the cause being given as
“ probably a n th ra x ; clinical symptoms all indicated anthrax.” The man died
fou r days after the appearance o f the first symptoms.
No. 135, o f Hodgenville, Ky., died at the age o f 81 on February 8, 1916, from
“ anthrax.” The infection was contracted, according to the attending physi­
cian, “ from a sick cow .”
No. 136, o f Johnstown, N. Y., died at the age o f 53 on February 13, 1916, o f
“ external a n th ra x ; chronic n eph ritis; m yocarditis.” H e was a w ool washer,
and the skins w ith w hich he was in contact ju st before getting anthrax infec­
tion came from South America.
No. 137, o f Chicago, 111., died at the age o f 46 on February 19, 1916. The
death certificate states that the man, who w as a tanner, died of “ gangrene
upper portion o f stomach and ascending colon from thrombosis o f the gastro­
epiploic dextra vessels; physician found anthrax.”
The physician testified
before the coroner’s ju ry that he was called on the case only a few hours
before death occurred. The patient had been feeling ill and without appetite
fo r tw o or three weeks, and had what he called1“ pimples ” on several parts o f
the body, one on the elbow being particularly severe. On the morning o f the
day he died he began to vom it and pass blood. On arrival the physician found
him extremely weak, with temperature down to 95°. There was also a swelling
on the patient’s jaw , extending to the neck, the peculiar appearance o f which,
in view o f the man’s being a tanner, made the doctor suspect anthrax. H e
punctured the lesion w ith his hypodermic syringe and1m icroscopically examined
the blood so obtained. Presence o f the Bacillus anthracis, and the fa ct that
the patient’s spleen was enlarged, made him “ positive that it is a case o f
anthrax infection.” A fter this testim ony the coroner’s ju ry gave a verdict o f
“ gangrene.”
No. 138, o f New York, N. Y., died at the age o f 15 on February 22, 1916,
o f “ anthrax.” An autopsy w as perform ed and anthrax bacilli were found.
No. 139, o f Boston, Mass., died at the age o f 41, on March 9, 1916, o f
“ anthrax.” H e w as a man o f good physique and had been employed as a
laborer handling un tanned hides in a tannery for about seven years. The at­
tack, characterized by “ marked edema o f face, neck and chest, weakness,
dyspn ea; irrationality,” began on March 4. H is physician referred him to a
Boston hospital, where he w as examined on March 5. The report o f the
examination states: “ Throat is considerably swollen and tonsil on the left is
greatly enlarged. Pharynx and uvula congested and the latter is much
elongated and flaccid. The le ft side o f the face and neck are edema­
tous. * * * Pressure over the swelling shows pitting on pressure with
exquisite tenderness. The edema is not sharply defined from the adjacent
tissues and arises very g ra d u a lly ; it is rather pink in color in contrast to the
surrounding skin. * * * Pulse thready and intermittent and often hard to
count. * * * The spleen is palpable and pressure in that region is very
painful. Tem perature w as 103.4°.” Treatm ent consisted o f elevating the
patient’s head, application o f an ice collar to his neck, and cold compresses to
his chest. A culture w as grown on agar-agar and showed anthrax bacilli.
The man died after five days’ illness.
No. 140, o f Boston, Mass., died at the age o f 32, on March 15, 1916, o f
“ anthrax pustule o f the skin o f the neck with associated edema o f larynx and
meningitis, and consequent asphyxia.” He was a longshoreman working on
hides. On March 8 a pim ple appeared on the left side o f his neck; there was




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BULLETIN OF TH E BUREAU OE LABOE STATISTICS.

gradual swelling, and swallowing became painful. A fter five days he went to a
hospital, where he was treated w ith hot corrosive poultices. Death occurred
tw o days later.
No. 141, o f Philadelphia, Pa., died at the age o f 35, on A pril 7, 1916, o f
“ anthrax.” H e had an “ external lesion 1 inch in diam eter on right posterior
cervical.” The third day after its appearance he was admitted to a Philadel­
phia hospital. The lesion was cut out and serum injected, but he died on the
sixth day o f illness. The man w as a laborer w orking in a hair shop on horse­
hair im ported from Argentina.
No. 142, o f Philadelphia, Pa., died at the age o f 50, on A pril 7, 1916, o f
“ anthrax.” He was a forem an and w oolsorter in a woolen mill, where the
physician thinks w ool from China w as used. On the second day o f the attack
he was adm itted to a hospital, w ith a lesion “ about the size o f a quarter ” on
his neck. The lesion was excised and serum injected. Anthrax bacilli were
found. On the fourth day o f the attack he died. In the hearings on his
w idow ’s claim fo r workm en’s compensation he is stated to have explained to
her that he had been struck by a sticker used in w ool sorting. The State
referee who heard the case aw arded the w idow and her five children $3,600,
but the State compensation board reversed this decision. On appeal the court
o f common pleas reversed the board’s action and reaffirmed the referee’ s award.
On still further appeal the aw ard w as finally confirmed by a ju stice o f the
State supreme court.
No. 143, o f Goldsboro, N. C., died at the age o f 54, on A pril 10, 1916, o f
“ anthrax, the febrile infectious disease due to infection w ith the Bacillus
a n t h r a c i s H e w as a farm er working fo r himself, and is reported to have
been ill for three months. Anthrax bacilli w ere found, and the treatment con­
sisted o f injections o f carbolic acid, w ith local applications o f ichthyol and
lanolin.
No. 144, o f Boston, Mass., died at the age o f 49 on April 16, 1916, o f
“ anthrax.” W hile wrorking as a teamster, handling and weighing dried hides
from South Am erica and Asia, he developed a carbuncle on the neck. H e w^ent
to a Boston hospital, where the pustule w as excised, but he died in fou r days.
Anthrax bacilli w ere found. No serum w as available. H is w idow w as aw arded
indemnity o f $5.07 a w eek fo r 500 weeks.
No. 145, o f Philadelphia, Pa., died at the age o f 64, on M ay 2, 1916, o f
“ anthrax.” H e w as a laborer and watchman, living in a little shed on the
grounds o f a shoddy works w hich handled curled hair from a felt company.
H e w as admitted to a hospital on A pril 30, the second day o f his illness, w^ith
an external abrasion one-half inch below the left eye, w hich w as swollen and
closed. The next day he w as transferred to a better equipped hospital where
the lesion was excised and serum injected. H e died on the fou rth day o f the
disease.
No. 146, o f St. James, Mo., died at the age o f 46, on May 19, 1916, o f “ an­
th rax (carbuncle on n e ck ).” H is death occurred nine days after the appear­
ance o f the carbuncle, w hich according to the physician wT “ due to the B a­
as
cillus a n t h r a c i s H e w as a laborer earning about $1 a day loading ties and
w ood on railroad cars, and he left one dependent, who received no indemnity.
No. 147, o f Glendale Springs, N. C., died at the-age o f 64, on M ay 21, 1916,
o f “ anthrax or malignant pustule— a genuine case o f the in fectiou s Bacillus
anthracis ” Deceased w as a farm er, and the physician w rites that the attack
“ w as undoubtedly contracted from a herd o f diseased sheep the victim owned
at the time o f infection. The disease manifested itself w ith a well-defined
pustule on the neck which was soon accompanied w ith marked prostration,




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87

exhaustion, and death. The patient at first had fever * * * but later the
temperature was subnormal. The case was well advanced before I saw it,
and no antitoxin was administered ow ing to the difficulty in getting it.”
Stimulants were administered and a supportive plan o f treatment carried out,
but the attack proved fatal in seven or eight days.
No. 148, o f Boston, Mass., died at the age o f 52, on June 2, 1916, o f “ anthrax
pustule o f the skin o f the Heck w ith associated edema o f pharynx and larynx
and consequent asphyxia.” The man was a currier in a tannery, handling
raw hides. T w o days before he went to the hospital a small pimple appeared
on the right side o f his n e c k ; during his three days’ illness there was increasing
swelling, which finally extended from ja w to chest. Corrosive dressings were
applied, but no serum was available.
No. 149, o f Philadelphia, Pa., died at the age o f 36, on June 26, 1916, o f
“ anthrax.” During his second week o f w ork in a glazed kid factory, remov­
ing hides from lime vats, he noticed a red spot on his left jaw , which he be­
lieved w as an ordinary pimple. On examination the physician found the spot
to be a “ hemorrhagic bleb beneath which w as a gangrenous eschar w ith a
dusky red infiltration, areola form , and edema.” The physician gave a diag­
nosis o f “ anthrax ” and ordered the patient to a hospital. “ At this time,”
continues the physician, “ he was wralking and complaining o f headache * * *
backache, and loose bowels. Respiration normal. Temperature 99° plus, and
urine showed albumin. The next day he developed a very high fever, violent
chills, and backache, most violent and bloody diarrhea, nausea, and vomiting.
A ll these symptoms came almost suddenly,” and an ambulance was called.
The city physician took two cultures, both o f which were positive. On the
afternoon o f the third day the patient developed convulsions, from w hich he
never regained consciousness. The treatment was symptomatic.
The man
had been making $15 a week. A charitable organization took up the case
and tried to obtain indemnity for the fam ily under the Pennsylvania w ork­
men’s compensation law. The referee decided in favor o f the fam ily, but the
insurance company appealed on the ground that anthrax was an occupational
disease and not subject to compensation under the act, in which contention it
was upheld by the State compensation bureau.
No. 150, o f Beaumont, Tex., died at the age o f 46, on June 29, 1916, o f
“ anthrax.” H e was a rice farm er, and kept some horses. H e went to a phy­
sician “ a few hours after he was bitten apparently by a fly.” A lesion de­
veloped on the low er front part o f his neck. At the end o f three days the
physician turned the case over to another practitioner, who immediately wired
New Orleans and Philadelphia fo r serum. B efore the serum arrived the patient
was dead. The second physician w rite s: “ W hile aw aiting the arrival o f the
serum we thoroughly excised the pustule and made free incisions for thorough
drainage o f the contiguous area, there being extensive edema over the entire
chest wall. A great quantity o f serum was evacuated through these incisions.
There w as pronounced improvement follow ing this w o r k ; he suddenly grew
worse, the tem perature rising to a registry o f 106°, and remained so until death
on the 29th.” The total duration o f the case was six days.
No. 151, o f Bordley, Ky., died at the age o f 53, on July 29, 1916, o f “ an th rax;
pyemia.” This woman w as a housekeeper; no details o f her illness were ob­
tainable.
No. 152, o f D etroit, Mich., died at the age o f 16, on August 12, 1916, o f
anthrax— inoculated w ith Bacillus an thracis; he worked in a curled hair fa c­
tory and only lived about fou r days after infection was discovered.” Serum
was used, but to no avail.




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B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

No. 153, o f San Antonio, Tex., died at the age o f 26, on September 7, 1916, o f
“ malignant pustule.” Further inquiry elicited the inform atioi} from the physi­
cian that it was a true case o f infection by Bacillus anthracis. No inform ation
was procurable as to how this young woman, who was doing housework, con­
tracted the disease.
No. 154, o f Cascade, Pa., died at the age o f 45, on September 30, 1916, o f
“ anthrax.” He w as engaged in transferring, among other freight, raw hides
and leather from a broad to a narrow gauge railroad. He was aware o f the
danger he ran, as he washed in a solution o f carbolic acid after handling hides.
He was stricken on September 23, the lesion appearing externally on the larynx.
Eichhorn’s serum was injected on September 26, 27, 28, and 29. Other treat­
ment, the physician reports, included “ phenol injected around sore, stimulants,
bichloride dressings, adrenalin nasal spray.” A w ife and seven children sur­
vived. The w idow applied for compensation, but after much contention the
claim w as disallowed on the ground that her husband was not an employee but
an independent contractor.
No. 155, o f Brooklyn, N. Y., died at the age o f 27, on October 21, 1916, o f
“ cellulitis o f face, anthrax in fe ctio n ; w orked in a brush factory.” The diag­
nosis o f anthrax was made by the coroner’s physician on the basis o f local
m anifestations supported by bacteriological examination. The -bureau o f pre­
ventable diseases o f the New Y ork City Department o f Health reports that the
factory where the young woman was employed made shaving brushes. “ Her
particular w ork consisted in tying bundles o f Chinese horsehair. Strings used
in this tying process have often been held in the mouth o f the worker. As
near as could be learned this w as not the case in this instance. There w as no
cut or abrasion, but within a few days after the development o f a small papule
on the arm, swelling rapidly spread, constitutional symptoms became severe
and she died at ---------- H ospital on the third day o f her illness. Subsequent
investigation o f the place o f her employment showed that the hair w as not
thoroughly disinfected and that another girl w orking in the same establishment
had several months before been reported to be suffering from anthrax w hich had
been cured.”
No. 156, o f Brooklyn, N. Y., died at the age o f 50, on October 31, 1916, o f
“ anthrax.” The bureau o f preventable diseases o f the New Y ork City Depart­
ment o f Health reports that he “ had fo r several years been a peddler o f
brushes used for various purposes in cleaning clothes and for household work.
He custom arily carried a large number o f these brushes tied on a string which
was thrown over his neck. The patient w as sick tw o days. H is first symptoms
were pain in the back, follow in g the development o f a small sore on the back
o f his neck, which was accompanied by enlargement o f the cervical and subm axillary glands. H is symptoms were so severe that the physicians called in
attendance thought they were dealing with a case o f meningitis and sent him
to ---------- Hospital. A t the end o f the second day the symptoms became ex­
tremely severe, stiffness o f the neck increased markedly and the patient passed
away. The coroner’s physician * * * made the diagnosis o f anthrax on
the basis o f the local m anifestations and bacteriological exam ination.”
No. 157, o f Falls Creek, Pa., died at the age o f 35, on November 26, 1916, o f
“ anthrax— Bacillus anthracis.” The man’s occupation is given as laborer.
No. 158, o f North Adams, Mass., died at the age o f 46, on Decem ber 17, 1916,
o f “ a n th ra x ; complete suppression o f urine after two days.” The man had
been handling hides in a tannery. The physician r ep orts: “ H is point o f infec­
tion was the left breast, where there appeared fou r pustules, accompanied with
much cellular edema, and he died o f acute suppression o f urine, due to a cloudy
sw elling o f cortex— this was determined by autopsy.” Death occurred after an




A N T H R A X AS A N O CCU PATIO N AL DISEASE.

89

illness o f five days. He left a w ife and two daughters. The w idow applied for
compensation, and the insurance company maintained that the man’s death w as
not caused by anthrax. A stubborn fight resulted. It was only after the body
was exhumed and an autopsy perform ed by a Boston medical examiner that the
w idow was awarded $8.02 for 500 weeks.
No. 159, o f New Haven, Conn., died at the age o f 54, on December 24, 1916,
o f “ anthrax— patient w orked in brush factory— due to the infectious febrile
disease due to inoculation with the Bacillus a n th ra cis” President and owner
o f a small brush and broom factory and form er member o f the Connecticut
Legislature, this man succumbed to anthrax after eight days o f illness. Eight
days before entrance to the hospital where he died, the deceased “ noticed a
small ‘ boil ’ on the back o f his neck. This gradually increased in size and
at the time o f his entrance to this institution it w as a typical anthrax pustule
about 2\ cm. in diameter.” H e arrived in a “ state o f coma and died a few
hours after arriving in the ward. H is jaw s w ere tightly locked and a sardonic
sm ile was present. There were occasional twitchings o f his face. Aside from
this the physical exam ination was negative. Smears were made from the pus­
tule but the organisms could not be found. A lumbar puncture was done, and
bloody spinal fluid was obtained in three test tubes, the fluid in the third tube
being more bloody than the other two. Post mortem examination revealed
typical meningeal lesions o f anthrax. The bacillus w as isolated in pure culture
from the spinal fluid.” Three days after the lesion on the back o f the neck
was first noticed, the patient cut his left index finger on a piece o f wire. “ Cul­
tures from this laceration also showed the presence o f the anthrax bacillus.”
The physician states that ventilation and washing facilities in the factory
were good. The im ported horsehair used w as supposed to have been disinfected
when purchased.
No. 160, o f Philadelphia, Pa., died at the age o f 51, on Decem ber 30, 1916,
“ o f anthrax, genuine anthrax due to Bacillus anthracis.” W hile employed as a
piecer and trimmer o f hides in a leather works, this man developed what he
thought w as a pimple on the left side o f his neck below the jaw. H e w as taken
to a hospital, the lesion was excised and serum injected, but he died seven days
after infection. Compensation o f $3,500, to be paid in weekly sums over a period
o f 10 years, w as awarded the w idow and four children. At the hearing on
the case, physicians showed that anthrax could be contracted through an
abrasion o f the skin, and it w as presumed that the deceased contracted it in
his work.
No. 161, o f Ursina, Pa., died at the age o f 64, on January 8, 1917, o f “ anthrax
infection.” The man handled hides in a tannery, where, as the testimony
before the workm en’s compensation referee brought out, “ inoculation took place
through a scratch or cut in the skin previously suffered by the deceased in
the course o f his employment * * * and * * * external anthrax re­
sulted therefrom .” In its decision the State workm en’ s compensation board
declares that, “ The time has arrived when we must enter into an exhaustive
study as to how fa r the invasion o f the human body by the germ o f anthrax
can be considered an accident suffered in the course o f employment.” “ In
several States,” the board continues, “ the idea has seemed to prevail that com­
pensation fo r anthrax should be granted where satisfactory evidence estab­
lished the entrance o f the bacillus into the body by means o f a wound or
break in the skin that had been suffered in the course o f employment. In
other words, the thought seemed to be that when it w as satisfactorily estab­
lished that a workman, in the course o f his employment, had sustained such
physical violence to his body that an open break o f his skin follow ed and the
bacillus anthrax had sought such a wound as the portal o f entry, it then could




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BULLETIN OF TH E BUREAU OF LABOR STATISTICS.

be called an infection naturally follow ing the original injury. In fact our
board in McCauley v. Imperial W oolen Company, and other cases o f admitted
anthrax,, has required the p roof o f an earlier injury in the course o f employ­
ment w hich would provide the portal o f entry for the anthrax bacilli. Is
this logical? ” Apparently the board answers its own question in the negative
and reverses its form er narrow attitude, for it goes o n : “ Given the anthrax
germ as a readily distinguishable identity with definite proportions coming in
contact w ith the human body and gaining an entrance into the same by means
o f a break in the texture o f the skin— wT is not that contact in itself violence
hy
to the physical structure o f the body? * * * I f a workm an has suffered
a break in his skin from any cause whatsoever and continues to prosecute his
daily employment, he can not be barred from compensation if any accidental
cause exaggerates or further develops that condition. I f a workm an has a
scratched or chapped hand or a sore upon his neck or a pimple upon his face,
and under the direction o f his employer handles skins, hides, or w ools infected
by anthrax bacilli, w e hold that the physical contact between that germ and
the portal o f entry thus previously existing is violence to the physical structure
o f his body, and that the w orkm an’ s experience in this respect constitutes an
accident in the course o f his employment. This situation is readily dis­
tinguished from the typical cases o f occupational diseases or those received
in the course o f employment o f untraceable inception and gradual and insidious
growth, such as those that we can not trace to being received at some certain
time, and in w hich there is no sudden or violent change in the condition o f
the physical structure o f the body.” The w idow was accordingly awarded
$4.50 a week for 297 weeks, until a daughter became 16 years o f age, and $4
a week for three weeks thereafter, making a total o f BOO wT
eeks’ compensation.
No. 1C2', o f Brooklyn, N. Y., died at the age o f 26, on January 14, 1917, o f
“ anthrax.” No bacteriological exam ination was made at the hospital where he
died, diagnosis being based on the medical history o f the case. Deceased was a
driver for a bakery and handled hay, straw, and grain, as well as bread.
“ Infection may have been due to contaminated hay, although this was not
proven.” He was ill only fou r days with malignant pustule under the right side
o f the chin. The lesion w as excised, but no serum w as available. T w o de­
pendents survived, but the w idow w as unable to secure indemnity under the
w orkm en’s compensation law.
No. 163, o f Munising, Mich., died at the age o f 48, on January 14, 1917, o f
“ anthrax, malignant pustules.” H e had w orked fo r five or six years as a
beam-house man in a tannery, and at the time o f infection had been scraping
South Am erican rawhides. H is wages were about $2.50 a day. He w ore can­
vas gloves at w ork. T he lesion w as on the left side o f his face, and the re­
port submitted to the State industrial accident board gave as cause and man­
ner o f accident, “ A pimple on his neck, evidently scratched by hands or shirt
collar.” The physician did not see him until tw o days before he died. Serum
w as at once sent for and injected intravenously, but no result w as obtained.
H e died on the seventh day o f the attack, leaving a w ife and three children
under 16 years o f age.
No. 164, o f Saguache County, Colo., died at the age o f 46, on January 23,
1917, o f “ anthrax.” H e w as a rancher w orking fo r him self, and had, as was
customary in the region, buried a ca lf that had died o f “ black leg.” H e had a
sore on his finger about 10 days before his death ; as the disease developed his
shoulder and chest became swollen and puffy and there was crackling under the
skin. Treatm ent consisted o f “ free incision to admit air— stimulation.” No
serum w as available. Anthrax bacilli were found in blood taken at death. The
man left a w idow and fou r children.




AN TH RAX AS AN OCCUPATIONAL DISEASE.

91

No. 165, o f New York, N. Y .y died at the age o f 49, on January 30, 1917, o f
“ anthrax, infection on neck, cause unknown.” The man had been a member
o f a w recking and repair gang for an elevated railroad company. A ccording
to the physician’s report, “ About three w eeks before the fatal illness he had
an attack o f lobar pneumonia from which he made an uneventful recovery. He
had been out o f doors but had not returned to work. H e had two pimples
(patient’s description) on side o f neck on January 25, but did not send for me
until January 30, when I found him dying— pulse 140, temperature 101°, respi­
ration 40— unable to swallow, entire neck and chest terribly swollen, entire
body dusky mahogany color o f sepsis, tw o large typical anthrax pustules on
side o f neck.”
No. 166, o f Camden, N. J., died at the age o f 37, on January 31, 1917, o f
“ anthrax (malignant pustule) o f anus and intestinal anthrax.” The man
was a ripper in a kid leather factory, w orking on dry salted raw skins im­
ported from India and South Am erica. H ot water, gloves, and disinfectants
w ere provided in the factory, and workmen w ere warned o f the dangers. The
lesion took the form o f a “ small pustule w ith dark center and swollen blebs
and swelling.” The lesion was excised and carbolized, and serum w as in­
jected. A nthrax bacilli were found. The patient died o f coma at the end o f
five days. H is fam ily, a w ife and five small children, was awarded compensa­
tion o f $10 a week for 300 weeks.
No. 167, o f Brooklyn, N. Y., died at the age o f 53, on February 10, 1917, o f
“ anthrax, malignant pustule.” H e w as a longshoreman, and had been handling
raw hides. He w as in the hospital less than eight hours. The first symptoms
appeared “ a few days ” previously.
No. 168, o f Philadelphia, Pa., died at the age o f 29, on February 12, 1917, o f
4 anthrax, due to Bacillus anthraeisJ* H is occupation is given as “ none.”
4
No. 169, o f Cedar Grove, N. J., died at the age o f 51, on February 16, 1917,
of “■
anthrax, infectious Bacillus anthracis.” She had for several years been
employed in a brush factory, and handled bristles from Russia and China.
H er neck and upper chest were swollen with edema o f the larynx. No serum was
available but “ mixed vaccines ” w ere used. She died after three days’ illness.
No-. 170, o f Newark, N. J.* died at the age o f 42, on February 25, 1917,
“ anthrax, Bacillus anthracis, cellulitis and edema o f glottis.” He was a
leather worker. H e went to a hospital on the fourth day o f the a tta ck ; an
operation for excision o f the ulcer w as perform ed immediately, but he lived
only 12 hours longer. According to a New Y ork newspaper, “ Although this
city and Philadelphia w ere searched fo r serum, none could be found in time.”
No. 171, o f Richmond, Va., died at the age o f 3, on M arch 1, 1917, o f “ septic
pyemia from carbuncle, anthrax, malignant pustule.” According to the local
coroner there is probably some doubt as to this being a case o f true anthrax.
No. 172, o f Port Allegheny, Pa., died at the age o f 53, on March 17, 1917, o f
“ anthrax.” H is occupation is given simply as 4 laborer.”
4
No. 173, o f W eymouth, Mass., died at the age o f 51, on March 24, 1917, o f
4 anthrax, proved in laboratory from culture taken after death.” H e w as a
4
w oolsorter employed by a wool-scouring concern. The lesion occurred on his
n eck ; m icroscopic examination o f a smear showed the bacillus, and a guinea
pig inoculation also proved positive.
No. 174, o f Chelsea, Mass., died at the age o f 64, on April 14, 1917, o f 4 an­
4
thrax septicemia secondary to pustule (an th rax) o f the fa c e ; occupational in­
fection.” H e was a w orking forem an in a shop making brushes for household
and factory use, w here he had been employed since 1881. H is particular duty
was to take charge o f the bristles and horsehair, imported from “ all over the
w orld,” principally from China and Russia. The material is described as un­




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B U L L E T IN OF T H E BU REAU OF LABOR STATISTICS.

clean, being much mixed with cow hair. It was disinfected in a jet o f live
steam, under 15 pounds pressure. The workmen were supplied w ith hot water,
nail brushes, gloves, and disinfectants, and were warned o f the danger. The
patient was not seen by a physician until April 11, some days after he had
begun poulticing the lesion. An operation was perform ed, but no serum was
available. M icroscopic examination and inoculation o f a guinea pig both were
positive.
No. 175, o f New York, N. Y., died at the age o f 23, on A pril 23, 1917, o f
“ anthrax.” The young woman was a stenographer employed by a concern
m anufacturing iron pipes. The m edical inspector o f the State industrial com­
mission reports that she “ was last seen at the office A pril 19, 1917, when she
complained o f chills and headache. A small pimple with a red-inflamed zone
was present on her cheek.” •One o f the deceased’s fellowT w orkers inform ed him
that she had recently bought a new muff, “ the fu r o f w hich showed dry white
scales,” which she was continually picking out. The mother inform ed the
inspector that the young woman had been ill with wT
hat they thought wT a
as
boil. Temperature was 104°. A fter a couple o f days her condition became
worse, delirium developed and she was taken to a hospital. A t the hospital a
smear was made from the pustule and anthrax bacilli w ere found. The patient
passed into a comatose condition and death occurred a few hours after entering
the hospital, the entire illness lasting four days. An examination o f fu r from
the muff gave negative results.
No. 176, o f Pleasantville, N. Y., died at a hospital in New York, N. Y., at the
age o f 37, on April 27, 1917, o f “ anthrax.” The man w as working as a land­
scape gardener on the grounds o f an orphan asylum in the Suburbs when he
contracted the disease. Opinions vary as to whether infection w as caused by
w orking on ground where diseased animals had been buried, by handling animal
manure, or from the use o f a razor strop made from the hide o f an infected
animal. The latter opinion was strengthened by the fa ct that he had cut him­
self while shaving a fewT days before infection set in. W hen the patient ap­
plied to a hospital, he was suffering from what looked like a series o f small
ulcers on the side o f face and neck w here there was great swelling, and he
complained o f intense pain. Eichhorn’s serum was hurried from W ashington
by special messenger and a total o f 100 c. c. was injected. The physicians were
preparing to operate fo r the insertion o f a silver tube to keep open the air
passage, but before the operation could be perform ed the patient lapsed into
unconsciousness and died in tw o hours. The attack lasted six days.
No. 177, o f Hutchinson, Kans., died at the age o f 26, on May 3, 1917, o f “ an­
thrax.” The history o f this case is scanty as the man was a M exican laborer
w orking on a floating railw ay gang. H e had been ill a week or more when he
reported to a physician. Treatm ent was “ incision and drainage.” No serum
was available. Anthrax bacilli were found.
No. 178, o f Boston, Mass., died at the age of 40, on May 12, 1917, o f “ an­
thrax, malignant pustule o f neck.”
Em ployed for tw o months as a lime
handler in the beam house o f a tannery, this man came in contact with dry
Chinese hides that had entered with a clean consular bill o f health, supposedly
disinfected in a 2 per cent solution o f hydrochloric acid and freed from blood­
stained m aterials by immersion in a 10 per cent salt solution. Conditions in the
tannery were reported as above the average. H ot and cold showers, soap, nail
brushes, gloves, w ere supplied for the workmen, and there was good special
ventilation. The first symptom appeared on May 9 in the form o f a pustule on
the right side o f the neck. Serum w as injected one-half hour after diagnosis.
The case appeared to be a very slight one until the second day, and the man died
on the day follow ing.




A N T H R A X AS A N O CCU PATIO N AL DISEASE.

93

No. 179, o f Chelsea, Mass., died at the age of 43, on May 24, 1917, o f “ an­
thrax pustnie o f neck with associated edema o f larynx (presum ably occupational
in fection ).” The man was ill six da ys; serum was available but w as not in­
jected. The deceased was a freight handler working on the wharves, and just
previous to infection had been unloading a consignment o f dried buffalo hides
from India. W ith the exception o f 19 bales, “ all o f these w ere stated to have
come from a district not infected with anthrax as fa r as known. * * * A
few o f the b'ales had been whitewashed, but none had been disinfected.” On
the day the man died all the firms which had received hides in that cargo were
notified o f this and another anthrax case (No. 181) apparently arising from it,
and were advised to take precautions.
No. 180, o f Evansville, Ind., died at the age o f 24, on May 26, 1917, o f “ an­
thrax.” He was a farm er raising corn, hay, and tobacco, and coming in con­
tact with mules, implements, manure, and fertilizer. Three days before death
he is said to have cut a pimple while shaving. H is face began to swell, and
he consulted a physician who diagnosed the case as anthrax and hurried, him
to a hospital. The physician states that there wT
ere “ vesicles around wound on
face, tissues o f neck and chest infiltrated, temperature typhoidal type.” No
anthrax serum was available, but streptococcus serum w as injected before the
laboratory test was completed. The bacteriological examination both by smear
and by culture proved positive for anthrax.
No. 181, of Boston, Mass., died at the age o f 29, on May 27, 1917, o f “ an­
thrax.” The disease took the internal form, which is rare in America, and
anthrax bacilli were found on autopsy. The official death certificate gives his
occupation as “ laborer,” but he was a freight handler w orking in the same gang
as No. 179. This single cargo o f India hides was therefore responsible for tw o
deaths o f American workmen.
No. 182, o f New York, N. Y., died at the age o f 36, on May 30, 1917, o f “ an­
thrax ; malignant p u stu le; acute alcoholic.” The death certificate states that
he was a “ laborer.” He was actually a stevedore employed by a warehouse
company, for whom he had been handling hides from South America. H e
w alked into the hospital the day before he died, com plaining o f a sw ollen neck
which had been bothering him for several days. Most o f the infected area was
excised, and E ichhorn’s serum was injected, but w ithout avail.
No. 183, o f Philadelphia, Pa., died at the age o f 31, on June 2, 1917, o f “ an­
th rax.” On May 7 the patient called a p h ysician ; at that time he had been ill
fou r days. There was “ external lesion on neck— great edema.” Serum was
injected intravenously in doses o f 140, 40, and 40 c. c., on May 12, 13, and 14,
respectively. The patient died after an illness o f three weeks. H e had been
employed as a teamster and handled bales o f sun-dried goatskins from India,
China, and South America.
No. 184, o f Boston, Mass., died at the age o f 53, on June 2, 1917, o f “ anthrax.”
H e was a currier in a tannery that used raw hides im ported from China. The
lesion, which was on the back o f the neck, was excised. Anthrax bacilli were
found. Serum was also used. H e was ill 5 days, and died in a hospital.
No. 185, o f Manchester, N. H., died at the age o f 48, on June 6, 1917, o f
“ anthrax— chronic alcoholism .” W hile working as a steam fitter in a tannery
where dry China hides were being used, he scratched his left fourth finger. He
went to the factory hospital, where he was treated for an ordinary infection.
On the night o f June 6, three days after infection had set in, he went into a
state o f coma and was taken to a hospital. A smear w as taken before death
occurred, and anthrax bacilli were identified m icroscopically. Serum was avail­
able but it w as too late to use it.




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B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

No. 186, o f Bow Creek, Kans., clied at the age o f 58, on June 12,. 1917, o f
“ anthrax infection left cheek.” “ Infection appeared on left cheek, spread to
involve entire cheek, eye socket, portion o f neck.” The victim was- a farm er
and stockman who treated his own and his neighbors1 stock. H e had treated a
’
horse that died o f a severe infection 10 days before his first symptoms appeared.
He treated him self w ith local antiseptics until tw o days' before Ms death. A t
that time, the physician states, it w as too late to use serum, had any been avail­
able. Tw enty-two days elapsed between the time the first symptoms appeared
and the man’s death. A nthrax bacilli w ere found upon m icroscopical examina­
tion.
No. 187, o f W altham , Mass., died at the age o f 50,. on June 15, 1917, o f “ in­
fection o f n e ck ; th rom bu s; malignant pustule.” “ There was n o m icroscopic
exam ination,” states the physician,, “ but the clinical symptoms pointed to
malignant pustule.” The man was a w atchm aker em ployed by a large concern,
and was ill only three days.
No. 188, o f Camden, N. J., died at the age o f 61,. on June 19, 1917, o f “ pul­
monary anthrax.” H e w as a laborer,, and had been employed in a tannery for
about nine months, w orking on horsehides in the raw-stock department,, at an
average daily wage o f $2.60. H e first complained o f Illness June 16, the diag­
nosis was made on the 18th, and death occurred the follow in g day. Serum was
injected. Anthrax bacilli were found in the blood and sputum. The company
gave a $100 burial benefit.
No. 189, o f Pittsburgh, Pa., died at the age o f 28, on July 1, 1917, o f “ septi­
cemia follow ing infection o f anthrax bacillus due to a boil on throat.” He
was a laborer in a steel mill. W hen removed to a hospital on the seventh day
o f illness he was unconscious and suffering from convulsions and rigidity of
the muscles. Death occurred tw o hours later. A nthrax bacilli were found on
blood examination. “ This case,” states the physician, “ resulted from a wound
on the chin caused by a razor cut. H is employment could not be considered
as a causative factor. H e had bought a new shaving brush.”
No. 190, o f Hazlett, N. J., died in a hospital at Long Branch, N. J., at the
age o f 35, on July 10, 1917, o f “ anthrax o f jaw , inoculation o f the Bacillus
anthracis.” H e w as a farm er.
No. 191, o f Roulette, Pa., died at the age o f 78, on July 18. 1917, tho cause
o f death being given as “ probably anthrax.” H e was a farmer.
No. 192, o f Elberton, N. J., died in a hospital at Long Branch, N. J., at the
age o f 21, on July 19, 1917, o f “ an th rax; proved Bacillus anthracis bacteriologically.” H e was a fisherman.
No. 193, o f San Francisco, Calif., died at the age o f 63, on July 30, 1917, o f
“ anthrax.” He was a rancher and had recently skinned a calf. The first
symptom in the form o f a pustule appeared July 25; 50 c. c. o f seYum were
injected intravenously July 29. Death occurred in a hospital the follow in g day.
No. 194, o f Shreveport, La., died at the age o f 67, on August 6, 1917, o f
“ anthrax.” He was a farmer. True anthrax w as “ demonstrated by bacillus.”
No. 195, o f Sonoma, Calif., died in a hospital at San Francisco, Calif., at the
age o f 55, on August 7, 1917, o f “ an th rax; septicem ia; acciden tal; infected
w hile skinning a cow.” H e w as a farm er and went to the hospital about August
6 “ complaining about a sore on his right w rist, claim ing to have scratched
>
it on barb w ire about a week previous. H e stated that he had treated the sore
him self w ith peroxide application and massage but it increased in size and he
decided to come to the city and have one o f our physicians look at it. An ex­
am ination disclosed a large reddened indurated area about 5 or 6 cm. in diam­
eter, and a slight distance above this affected part wT another slightly reddened
as
area. The large indurated area w as o f violet-red color with some vesical




A N T H R A X AS A N O C C U P A TIO N A L DISEASE.

95

form ation.” On questioning the patient, the physician found that he worked
a small farm. Right after receiving the scratch he had skinned a calf that
had died o f some unknown cause the night before. The sore developed a few
days later. The physician had smears taken from the inflamed area and
‘‘ characteristic anthrax bacilli were found to exist.” The patient was put to
bed in a hospital with a temperature o f 102°. “ H is condition rapidly became
worse, and he complained o f spots before his eyes and difficulty in distinguish­
ing objects in the room. H is temperature went up to 106° and he became
septic. A blood culture w as taken as well as some smears. The bacilli were
so thick in the blood that there w as no difficulty in seeing them in an ordinary
smear.” The patient died the follow ing morning. A few hours later the w ife
came to the physician, alarmed about a sore on her arm. She was also suffering
from anthrax. The pustules w ere excised and she recovered. It later devel­
oped that she also had handled the dead ca lf and that it w as cut up and some
o f the meat given to friends. The skin w as sold to a butcher for $1. The
death o f one o f the helpers on the farm w as reported to have occurred from
an unknown cause within a day o f that o f the farm er (possibly No. 196).
No. 196, o f Sonoma, Calif., died at the age o f 66, on August 8, 1917, o f
“ anthrax.” H is occupation is given as laborer.
No. 197, o f Clymer, Pa., died at the age o f 59, on August 12, 1917, o f “ an­
thrax.”
“ Culture,” according to the physician, “ showed virulent anthrax
bacillus.” Infection lasted tw o days, antiseptic and constitutional treatment
being given. Deceased w as a carpenter.
No. 198, o f New York, N. Y., died at the age o f 35, on August 16,* 1917, o f
“ a n th ra x ; sepsis.” H e w as a clothing operator, sewing woolen trousers. The
medical inspector o f the State industrial commission r ep orts: “ He noticed a
stiff neck on Sunday morning and on Monday he noticed a pimple under chin
with a swelling extending to right cervical glands.” T w o physicians were
c a lle d ; they made no diagnosis but picked the skin and painted it with iodine.
On W ednesday the patient w as sent to a hospital, where a bacteriological
diagnosis o f anthrax was made. T w o hours after entering the hospital the
patient wT
as operated on. “ Operation consisted o f excision 1 'inch around
pustule and application o f powdered m ercury bichloride to w o u n d ; 50 c. c. o f
serum w as injected every 12 hours. Patient died Thursday night ” — the fifth
day o f the attack.
No. 199, o f Harney, Md., died at the age o f 39, on August 26, 191», o f “ an­
thrax (m alignant p u stu le).” The disease began as an external pustule on the
cheek, and abdominal com plications developed, leading to “ internal anthrax.”
Serum w as obtained w ith difficulty and tw o intravenous injections o f 20 c. c.
each w ere made. The patient died at the end o f 16 days, leaving a w ife and one
child. According to the physician the deceased w as owner o f three farms, mail
carrier, and director o f a reducing plant for which he canvassed the farm ers
in his locality with samples o f fertilizer. H e fed his own hogs the “ tankage ”
which the company made from the flesh o f dead animals. T h e physician did
not think that anthrax could have been contracted from contact with either the
fertilizer or tankage, but cites as the most probable source o f the infection the
fo llo w in g ; “ Last winter they killed a hog on one o f his farm s for purpose o f
butchering, when they discovered it wT diseased, having external sores. H e
as
brought part o f this diseased hog home and placed it upon some boards in his
cellar. Each day they would boil some o f the meat and feed it to their chick­
ens.” H e handled those boards in building a potato scaffold a few days before
the pustule appeared.
No. 200, o f Sacramento, Calif., died at the age o f 67, on September 3, 1917,
o f “ anthrax.” H e was a farm w orker, whose special duty was to care for




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BULLETIN OF TH E BUREAU OF LABOR STATISTICS.

cattle. It was thought that he contracted the disease from mosquitoes or flies
or from animals that had died o f anthrax. It is stated that cattle which died
o f disease were burned with crude oil, and that gloves and pitchforks were
furnished for this work. The man’s illness lasted three days. Serum w as injected.
No. 201, o f Liberty, Mo., died at the age o f 70, on September 22, 1917, o f
“ anthrax, inoculation with Bacillus an thracis; m alaria.” H e w as a physician.
D uration o f illness is given as fou r weeks.
No. 202, o f La Junta, Colo., died at the age o f 76, on September 25, 1917,
o f “ anthrax.” H e had been a ranch laborer all his life and at the time o f
infection was working in bean fields. The first symptoms appeared Sep­
tember 16, but a physician w as not called until the 23d. A t that time the
physician considered the case too fa r advanced fo r the use o f serum, but other
m edical and surgical treatment was given. A nthrax bacilli were found. Death
occurred on the tenth day o f the attack.
No. 203, o f Cabarrus County, N. C., died at the age o f 7, on September 26,
1917, o f “ ed em a; anthrax.” Physician states that death w as “ due to Bacillus
anthracis.”
No. 204, o f Colchester, Yt., died at the age o f 31, on October 5, 1917, o f
“ anthrax.” Upon inquiry the physician amplified this diagnosis into “ infec­
tious febrile disease due to inoculation with Bacillus a n t h r a c i s Deceased
was a laborer.
No. 205, o f W oburn, Mass., died at the age o f 54, on October 12, 1917, o f
“ anthrax.” He was a currier, handling Chinese cowhides in the beam house
o f a tannery. Death occurred on the eighth day o f the attack. The physician’s
report states that this was the third case o f anthrax evidently contracted from
contact with hides carried on a certain ship. *He asks, “ Is the hold o f the ship
infected with spores o f anthrax b a c illi? ”
No. 206, o f New York, N. Y., /lied at the age o f 28, on October 18, 1917, o f
“ anthrax due to the Bacillus anthracis.” H e w as a peddler o f hardware, and
the physicians w ere unable to learn how he contracted the disease. The first
symptom appeared on October 14, “ approxim ately fou r days previous to ad­
mission ” to the hospital. Anthrax bacilli were found in direct smear and in
blood culture. No serum w as given, “ patient dying soon after admission.”
The lesion occurred on the left side o f the face ju st above the low er jaw .
No. 207, o f Gridley, Calif., died at the age o f 50, on October 21, 1917, o f
“ anthrax.” This farm laborer thought he was suffering from spider bite on
the right side o f his face when he called on a physician on October 19. The
physician treated the “ b i t e ” w ith antiseptics. The next day he felt better,
but at 4.30 p. m. on the 21st he was in a state o f collapse, and at 7.30 that
evening he died1 An autopsy was perform ed and anthrax bacilli found in the
.
blood. Tw o cows had died o f anthrax about 2 miles from the ranch where the
deceased worked.
No. 208, o f M ilwaukee, W is., died at the age o f 43, on October 22, 1917, o f
“ anthrax.” H e w as a hide stripper and handled South Am erican hides in a
tannery. These hides, according to the tannery’s report, had been washed
and disinfected in bichloride o f mercury solution in accordance w ith Government
regulations. The workmen w ere not warned o f their danger, as the employers
“ did not expect trouble.” This tanner’s first symptoms appeared on October
17. The physician operated on the 19th, the lesion being on the neck. General
toxem ia w as contributing cause o f death. Serum w as injected. A w idow
survived, who received no indemnity.
No. 209, o f W oburn, Mass., died at the age o f 66, on October 27, 1917, o f
“ anthrax.” W hile handling Chinese cowhides in the beam house o f a tannery
he becam e infected in the neck. H e w as ill for only three days.




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97

No. 210, o f Elkland, Pa., died at the age o f 20, on November 4, 1917, o f
“ malignant anthrax edema, laryngeal.” H is occupation is given as laborer.
No. 211, o f Lackawanna, N. Y., died at the age o f 35, on November 9, 1917,
o f “ anthrax.” H e first noticed a small pustule on his neck on November 7.
The physician first saw him the evening o f the 8th. H e was “ moribund ”
and “ had pustule lesion on neck ju st below larynx, center blackened and de­
pressed, bluish red areola around pustules and extensive edema o f skin ex­
tending up the neck to his face and down the front o f chest to the edge o f the
ribs. Temperature 99°, pulse 200, respiration labored, possibly pulm onary
involvement.” It w as the first anthrax case the physician had seen. The
“ peculiar appearance o f the lesion on the neck, the extrem e edema around it,
and the extreme prostration ” led him to suspect anthrax. “ The smears and
cultures revealed the presence o f anthrax bacilli.” The patient was treated
wT
ith stimulants and local dressings, but died the morning o f November 9. H e
was a switchman on a railroad, and the physician w as unable to determine th e
source o f infection. Am ong suspected agencies w ere contact w ith freight cars*
a lamb’s w ool collar on a coat the patient w ore, and some leather w ith w hich
he was resoling his shoes. There w ere no other known cases in the vicinity.
A w idow and two children survived.
No. 212, o f Milwaukee, W is., died at the age o f 26, on November 10, 1917,
o f “ anthrax infection.” H e was a salesman fo r an eastern brush com pany.
A small vesicle appeared on his neck on November 5. It swelled to such an
extent that three days later he consulted a physician, his w hole side being then
edematous. Exam ination showed the “ very plentiful ” presence o f anthrax
bacilli, and 250 c. c. o f serum w ere injected intravenously. He left a widow.
No. 213, o f New York, N. Y., died at the age o f 30, on November 17, 1917, o f
“ anthrax.” H e was a longshoreman and “ declared positively he had n ot
handled hides ” or wool. H e thought he had a boil on his neck, but anthrax
bacilli were found in the vesicular fluid. One dose o f 50 c. c. o f Eichhorn’s
serum was injected. H e died at a hospital five days after noticing the sore,,
anthrax toxem ia being involved.
No. 214, o f Brookhaven, N. Y., died at the age o f 23, on November 20, 1917,.
of “ a n th ra x ; origin o f infection unknown.” H e wT a cook at Camp Upton.
as
There w as “ lymphemia and infection o f cerebrospinal fluid w ith the anthrax
bacillus, probably originated,” states the physician, “ by intestinal infection.’*
No. 215, o f Salinas, Calif., died at the age o f 47, on November 22, 1917, o f
“ anthrax.” He had been a rancher all his life. Serum was used. H e died
after nine days’ illness, the last tw o o f w hich w ere spent in a hospital. It is
reported that he wT warned not to skin a dead animal.
as
No. 216, o f W oburn, Mass., died at the age o f 45, on November 27, 1917, o f
“ vagus pa ra lysis; infectious febrile disease due to inoculation with Bacillus
anthracis.” H e was a currier, handling dry oxhides and cowhides in a tannery
beam house. Lesion was on the right cheek, and a smear proved positive fo r
anthrax bacilli. The State health department report on the case notes that
there had been eight cases o f anthrax in 1917 among leather workers and hide
handlers coming in contact with hides shipped by one Chinese export company.
The disease in this case lasted five days, death occurring in a hospital. Live
steam and bichloride dressings w ere applied.
No. 217, o f W illiam sport, Pa., died at the age o f 41, on November 29, 1917,,
o f “ anthrax o f heart and k id n eys; asphyxiation from edema.” H e was a
farmer.
No. 218, o f Philadelphia, Pa., died at the age o f 44, on December 3, 1917, o f
“ a n th ra x ; septicemia.” H is occupation is given merely as “ laborer,” but h is
141633°— Bull. 267— 20------ 7




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B U L L E T IN OF T H E BU BEA U OF LABOK STATISTICS.

work was to load wagons with wool trimmings from hides. He carried great
loads of this material in his arms, and the physician thinks some of it came in
contact with a pimple on his neck, about 2 inches above the collar bone, and
caused infection. The physician reports that on admission to the hospital two
days after the swelling began, the patient’s external appearance was toxic.
Extremities and face were badly cyanosed, and there was difficulty in respira­
tion.
The neck was “ red, tender, and painful; * * * many vesicles
* * * in region of clavicles; on the left side of the neck * * * a small
pustule about the size of the head of a hatpin.” Four days later the condition
was much worse, with increasing edema, slight delirium, labored respiration and
frequent vomiting. The patient was unable to take food and died at 1.45
the following day from “toxemia and cardiac failure, due to overwhelming
anthrax infection.” Diagnosis was “ based on smear, culture, and history of
exposure.”
No. 219, of Beaumont, Tex., died at the age of 47, on December 6, 1917, of
“ anthrax.” “ The patient,” reports the physician, “ was apparently bitten by a
fly or mosquito. The small lesion remained local for about five days with
increasing itching, redness, and pain. It then became general, with excessive
exudation and swelling of the upper part of the chest. Later fever became
high, the patient became delirious, and the swelling of the upper part of the
chest and neck increased and the patient died of general toxemia and asphyxia
from swelling of the neck.” He was ill 11 days in all and left a wife and
children. The deceased was a self-employing rice farmer. The physician adds:
“ The disease is prevalent here most every year among horses and cattle, and a
number of cases among human beings occur, most of them being local infections
and resulting in recovery.”
No. 220, of Portville, N. Y., died at the age of 54, on December 7, 1917, of
“ anthrax.” He was a farmer.
No. 221, of Boston, Mass., died at the age of 40, on December 19, 1917, of
4 anthrax pustule of the neck with associated edema of the larynx, and
<
septicemia.” His occupation is given on the official death certificate as
“ chemical worker, tannery,” but he was actually a laborer for a chemical
company who unloaded from a truck some carboys of chemicals for a tannery.
Six months before infection he had worked at a tannery in Winchester. The
physician thinks there “ may have been spores in clothing w orn.” The lesion
T
was on the right side of the neck. The patient went to a hospital the third
day of his illness, and bichloride dressings, 1/1000 and 1/3000, were applied,
but he died the following day. Smear and blood culture proved positive for
anthrax bacilli.
No. 222, of Norwalk, Conn., died at the age of 15, on December 23, 1917, of
“ anthrax of face.” He was a schoolboy.
PR OBABLE RATIO OP DEATH S TO TOTAL N U M BER OF CASES.

Because o f the variety and the incomplete nature o f the material,
any attempt to estimate the probable ratio o f fatal to total cases
o f anthrax is surrounded with difficulty. In the course o f this study,
data giving figures fo r both fatal and nonfatal cases were secured
from a number o f different sources, including a company physician,
the infectious-disease reports o f fou r States,* occupational-disease
reports in two States, four hospitals, and a State workmen’s com­
pensation commission. The proportion o f fatal to total cases varied
widely, from 3 out o f 48, or 6 per cent, in the experience o f the




A N T H R A X AS A N O CCU PATIO N AL DISEASE.

99

company doctor, to 15 out of 18, or 83 per cent, in the figures reported
for two years to the New York State Board o f Health.
Upon closer examination, however, the discrepant figures seem to
be susceptible of considerable adjustment. The ratio of fatalities
experienced by the physician in question was probably extraordi­
narily low, due in part to his being employed directly by the tannery
companies, so that he received the cases in the early stages, and in
part to his considerable experience with the disease and the conse­
quent development of a more successful treatment. The reports from
the four State boards of health all covered periods of two years or
less, and showed, respectively, a fatality rate of 2 cases out of IT, or 12
per cent (Massachusetts), 4 cases out of 17, or 24 per cent (Texas), 3
cases out of 5, or 60 per cent (California), or 15 cases out o f 18, or
83 per cent (New Y ork). The wide range displa}^ed by these fig­
ures from similar sources is remarkable. Perhaps the largest single
factor o f error they contain is that deaths from anthrax are likely
to be reported as a matter of routine with all other deaths, but
that reports of nonfatal cases are more likely to be neglected.
This would tend toward a preponderance of fatalities among the
cases reported, a tendency the effect of which is evidenced by the
fact that three of the ratios in this group are higher than the median
ratio secured, and that two of them are the highest obtained from
any source. Moreover, the low ratio in this group, that from Massa­
chusetts, covers a period of only two months and four days, while
there was an epidemic of the disease in that State, so that the figures
are likely to be unusual.
Another group of figures,, those secured through the occupationaldisease reports of two States, shows a similar diversity, the New
Jersey ratio for nearly four years being 1 fatal case out of 13,
or 8 per cent, while the New York ratio for a slightly longer period
was 13 fatal cases out o f 23, or 57 per cent. Occupational-disease
reports, however, are likely to suffer from the defects already men­
tioned as affecting infectious-disease reports, and from the further
circumstance that the occupational disease reporting laws are com­
paratively new, are not even yet known to all physicians to whom
they apply, and for business reasons are not so likely to be lived
up to or enforced. The figures from the Massachusetts Workmen’s
Compensation Commission showed 3 fatal cases out of 30 in which
claims for compensation were made in three years, or 10 per cent.
Data secured from such a source should be fairly complete; but, since
the ratio is the third lowest in the series, it is probably best not to
attach too much importance to it.
The figures which from the standpoint of accuracy of diagnosis
and completeness of recording are probably most valuable for the




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B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

purpose in hand are those from hospitals. Returns from four of
these institutions for widely varying periods were secured, and it is
interesting to note that the ratios they present group closely together
near the middle of the range o f ratios studied. Thus two Massa­
chusetts hospitals had, respectively, fatality rates of 6 out of 35,
or 17 per cent, and 2 out o f 4, or 50 per cent. A Philadelphia
hospital had 6 fatal cases out of 32, or 19 per cent, while a New
Orleans institution had 1 out of 5, or 20 per cent. The first,
third, and fourth o f these ratios are in substantial agreement; the
variation shown by the second set of figures is possibly due to their
coming from a small hospital in the same city as the much larger
institution from which the larger number o f cases was reported.
I f the three sets of hospital figures which are in closest agreement,
and which incidentally include the largest numbers of hospital cases
reported, are taken as a reasonable gauge, the probable proportion
o f fatal to total cases would seem to be about 1 out of 5, or 20 per
cent.1
L E G IS L A T IO N .

American legislation regarding anthrax deals (1) with the re­
porting o f cases, (2) with measures for prevention, and (3) with
compensation or insurance for those who contract the malady in the
course of employment. In none of these fields is the legislation as
thoroughgoing, as widespread, or as vigorously enforced as the sit­
uation demands, but the beginnings have been made and further
study of the subject should result in its extension and substantial
improvement.
REPORTING.

In the United States, as in most civilized countries, the value o f
reporting or notifying infectious diseases is generally recognized.
Mortality statistics compiled from the official certificates of death
indicate roughly the geographical distribution of a disease and its
trend toward higher or lower frequency. As has been seen, however,
the mortality statistics o f anthrax cover but about one-fifth of the
total number of cases, and therefore fail to give any adequate infor­
mation on its actual extent, occupational causation, and numerous
other features o f social interest. Still more important, only by re­
porting infectious diseases as soon as diagnosed can epidemics
be recognized, checked, or prevented.
Reporting o f human anthrax is, nevertheless, a comparatively re­
cent advance in this country, being required, even as late as July,
1
T his figure is in substantial accord w ith that o f the B ritish authorities, Bell and
Legge, who state that “ In Europe about 25 per cent o f all cases prove fa ta l.”
(A llbu tt
and R o lle s to n : System o f M edicine, 1906, p. 252.)




A N T H R A X AS A N O C C U P A TIO N A L DISEASE.

101

1911, in only seven States. But because of the growing frequency
of anthrax, together with more lively interest in occupational as
well as infectious diseases, reporting laws spread rapidly, and by
January, 1916, anthrax had been made notifiable in the following
24 States and in Porto R ico:
Alabama, California, Connecticut, Delaware, Florida, Illinois,
Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Min­
nesota, New Hampshire, New Jersey, New York, Ohio, Pennsylvania,
Rhode Island, South Carolina, South Dakota, Texas, Vermont,
and Washington.
In most of these anthrax is, on the list of notifiable infectious
diseases, and reports must be sent to the local board of health
or health officer, by whom they are transmitted to the State board
of health. The obligation to report usually rests upon the phy­
sician, and in some States, if there is no physician in attendance,
any other person knowing of the case is required to report it. Some
States provide for the payment of a small fee to the physician or
other person making the report. In New York, for instance, the
fee is 25 cents in cities and 20 cents in villages and towns. In Mich­
igan and New Jersey, 10 cents is paid, whereas in some States, such
as Connecticut and California, the person reporting is entitled to
50 cents. Failure to report is usually punished by a fine, varying
from $5 in Maryland to $50 in New Jersey. In some States the
provisions for enforcement are more stringent. Thus in Washington
the State board of health may remove from office any health officer
who refuses or neglects to make prompt and accurate reports.1
In addition to requirements for notification of infectious diseases,
12 of these States2 have adopted statutes or administrative orders
requiring physicians to report, as an occupational disease, every case
of anthrax “ contracted as the result of the nature of the patient’s
employment.” The standard certificates used under these statutes
are usually made returnable to the State board of health, which
often must transmit them to the State department of labor; some­
times, however, the reports go directly to the labor department. The
blanks are more detailed than the ordinary infectious-disease blank,
asking, in addition to the name and address and nature of the illness
of the employee, his occupation, length of time therein, and the
1 A cco rd in g to th e w eek ly U n ited S ta te s P u b lic H e a lth R eports th ere w ere reported
d u rin g th e y ear 1 9 1 9 , un der th e in fe c tio u s d ise a se rep ortin g law s, 7 6 cases o f a n th rax,
d istr ib u te d a s fo llo w s : C a lifo rn ia , 1 4 ; C olorado, 2 ; C o n n ecticu t, 2 ; D elaw are, 3 ; G eorgia,
1 ; Illin o is , 2 ; K a n sa s, 1 ; L o u isia n a , 1 ; M aryland, 1 ; M a ssa c h u setts, 1 3 ; M ississip p i, 1 ;
M ontana, 3 ; N ebraska, 3 ; N ew H am p sh ire, 1 ; N ew Jersey, 4 ; N ew York, 1 7 ; Ohio, 2 ;
O regon, 1 ; V erm ont, 1 ; W est V irg in ia , 2 ; W isco n sin , 1. F or sp e cia l d isc u ssio n o f an ­
th ra x rep o rts received under th e in fe c tio u s d ise a se rep o rtin g la w s o f P e n n sy lv a n ia and
M a ssa c h u setts, se e pp. 3 1, 38, a n d 9 9 .
2 C a lifo rn ia , C onnecticut, M aine, M aryland, M a ssa ch u setts, M ichigan, M innesota, N ew
H am p sh ire, N ew J ersey , N ew York, Ohio, an d R hode Islan d .




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BULLETIN OF THE BUREAU OF LABOR STATISTICS.

employer’s name, address, and business. A careful study of occupa­
tional hazards is thus facilitated. Two o f these 12 States (Cali­
fornia and Connecticut) offer a 50-cent fee as an inducement toward
more thorough reporting; penalties for failure to report range from
$5 to $50, while Minnesota provides as alternative to a $10 fine,
imprisonment for not more than 10 days.1
PREVENTION .

The story told by such statistics o f anthrax as the present mor­
tality registration and disease-reporting laws have made available
is one o f steadily and, of late, even sharply increasing prevalence.
The cause o f this condition must be sought in the incomplete and lax
character of existing efforts at prevention, both in agriculture and
in trade and manufacture, especially in the latter.
A griculture.

Since anthrax in man is practically always the result of contagion
in some manner from animals, one essential in eradicating the dis­
ease is to prevent it among animals. Laws and regulations for the
suppression of animal anthrax have been enacted in all civilized
countries and in all the large stock-raising sections of the United
States.

Congressional action covering this matter dates from 1865, when
an act was passed prohibiting the importation of cattle from any
foreign country into the United States.2 The Secretary of the Treas­
ury was, however, given power to suspend the prohibition whenever
he determined that such importation would “ not tend to the intro­
duction or spread of contagious or infectious diseases among the
cattle o f the United States.” Except for an extension to be men­
tioned later, this provision has been embodied practically unchanged
in successive tariff laws, and to-day forms subsection 1 o f Section
IY -H o f the tariff act o f October 3, 1913. Under its terms importa­
tions of neat cattle were permitted in the summer o f 1916 only from
Great Britain, Ireland, the Channel Islands, New Zealand, and
North America. In 1884, with the organisation of the Bureau of
Animal Industry in the Department o f Agriculture, the formulation
of rules governing importations of live stock was taken over by that
department.
1 For summaries of cases reported under the New York and the New Jersey occupa­
tional disease reporting statutes, see pp. 35 and 8 7 .
In New Hampshire 2 cases Were
reported under this law in 3915. Both patients were laborers in a tannery, and both
recovered. In- Maryland the remarkable case was reported in 1914 of a 15-year-old boy
who contracted the disease while working as a doffer in a woolen m ill.
3 United States# Statutes a t Large, Vol. X I V , p. 1 .




A N T H R A X AS A N OCCU PATIO N AL DISEASE.

103

In most States, also, the regulations do not refer specially to
anthrax, but apply to infectious cattle diseases in general. Almost
all of these States forbid the importation of animals affected with
contagious or infectious diseases. Cases of such diseases must be re­
ported, and an official o f the veterinary department is required to in­
vestigate, to examine the stock, and to prescribe necessary measures
for the protection of healthy stock. Diseased animals or those which
have been exposed to the disease must be quarantined. To prevent
further spread of the disease many States prescribe the killing o f
affected or exposed animals; frequently in such cases an official or a
committee appraises the animals and the owner is compensated for
the loss. Complete and careful destruction of carcasses of animals
dying of the disease and disinfection of their stalls are also required.
Failure to comply with the regulations is punishable by a fine
ranging, for ordinary offenses, from $5 to $500. Penalties as high
as $5,000 may be levied in Tennessee for importing diseased stock,
and in Virginia for failure to disinfect freight cars.
Several States, however, chiefly in the West and South, where
stock raising is an important industry and where anthrax is prev­
alent, have prescribed measures specifically for the prevention and
eradication of this scourge. These measures are on the whole similar
to the general regulations just described. Periodic vaccination of
herds, which is compulsory in a number of countries abroad and
which has proved its effectiveness as a preventive measure, is strongly
advocated by agricultural stations in this country but is required in
only a few States. In Kentucky, vaccination is prescribed for all
animals which have been exposed to the disease. The vaccine must
be approved by the United States Bureau of Animal Industry, by
the Kentucky Agricultural Experiment Station, or by the State live
stock sanitary board. In Pennsylvania the State live stock sanitary
board, according to one of its officials, prepares and distributes to
qualified veterinarians, free of cost, anthrax vaccine for use on ex­
posed animals. Early each spring, for years, it is reported, the
board has vaccinated the stock on all premises where anthrax is
known recently to have existed. Formerly the vaccine was furnished
free o f cost and the work carried on at the expense of the State.
Since 1916, however, the State merely supplies the vaccine and does
not pay for its administration. Similar precautions are being taken
in other States.1
1 D u rin g J u n e and J u ly o f 1 9 1 6 ser io u s a n th r a x outbreak s occurred am on g c a ttle in
th e n eig h b o rh o o d o f B uffalo, N. Y., in A rk a n sa s and T ex a s and in th e M ississip p i D e lta
r egion o f L o u isia n a . P ro m p t w ork by S ta te v e te r in a r y officers in k illin g in fe c te d c a ttle ,
sec u r in g th eir bu rn in g or deep b u ria l in qu ick lim e, v a c c in a tin g exp osed herds, and esta b ­
lis h in g q u a ra n tin es, succeeded in ch eck in g th e p lagu e.
S everal hu m an cases w ere re­
p orted in th is co n n ectio n , in c lu d in g th e d e a th o f th e S ta te v e te rin a r ia n o f T exas.




104

B U L L E T IN OF T H E BU KEAU OF LA B O R STATISTICS.
Trade and M anufacture.

The question of prevention of anthrax among industrial workers,
which is the subject o f extensive legislation in the leading countries
o f Europe, has so far received little attention in the United States.
Not a single special factory or workshop regulation for the safe­
guarding o f employees against this disease has yet been enacted
by any State. What governmental precautions do exist refer only
to the importation o f dangerous animal materials and until January
1, 1917, these were limited in application to hides and glue stock
from “ neat cattle.” The dangers lurking in imported hair, wool,
and bristles, in horsehides, and in goat and sheep skins were com­
pletely ignored.®
Imports for the six years ending June 30, 1915, of animal materials
liable to carry anthrax are shown in the following table, in which the
figures represent thousands of pounds:*
T able

7 .—IM PORTS OF A NIM AL PR O DUCTS L IA B L E TO B E IN F E C T E D W ITH

A N T H R A X , 1910 TO 1915.
(Compiled from reports of U nited States Bureau of Foreign and Domestic Commerce on imports of mer­
chandise into the U nited States. Figures represent thousands of pounds.]
Year ending June 30—

Materials and the country from which
exported.
1910

1911

1912

1913

1914

1915

H ID E S A N D S K IN S , R A W O R U N C U R E D .

Dry:
T o ta l........................................................ i 608,615
South America........................................ i 152,802
Asia.......................................................... 189,235
17,490
Africa.......................................................
Green or pickled:
Total.........................................................
(2)
South America........................................
(2)
Asia..........................................................
(2)
Africa.......................................................
(2)

177,746
51,639
45,433
6,593

234,914
76,324
45,515
6,317

257,373
55,972
72,177
6,432

231,183
54,107
60,873
5,676

209,119
71,085
64,881
13,777

197,140
27,295
22,345

302,849
57,656
26,331
22

314,817
52,504
26,995
399

329,880
71,809
23,440
1,209

329,095
135,191
18,835
420

W O O L , H A IR OF T H E C A M E L , G O A T , A L P A C A ,
A N D O T H E R L I K E A N IM A L S , M A N U F A C ­
TURED.

137,646
193,399
195,292
Total................................................................ 263,927
247,645
21, 021
South America...............................................
37,341
30,626
29,188
47,504
Asia................................................................. 50,679
59,921
38,987 44,343
121
342
387
Africa..............................................................
145
711
H O R SE A N D

308,081
95,734
55,415
40,959
25,068

O T H E R A N IM A L H A IR M A N U ­
FACTURED.

18,759
2,941
130

7,534
2,426
75

16,176
2,625
343

16,495
2,313
451

14,245
1,573
200

11,689
1,872
416

3,461
3,578
4,029
3,553
Total................................................................
1,722
Asia................................................................. 1,483
1,491
1,565

3,436
1,592

4,061
2,482

Total................................................................
South America...............................................
Asia.................................................................
B R IST LE S.

1 In clu d in g dry, green, and picked h id es and skins.
2 In cluded in dry h id es and skins.
° C ertain r eg u la tio n s did e x ist regard in g th e d isin fec tio n o f w ool, horse, and o th er hair
Im ported from S ou th A m erica, but th ese had reference only to foot-and-m outh d isease.
(T r e a su ry d ecisio n s 3 0 7 8 3 , J u ly 1 3 , 1 9 1 0 , and 3 202T , N ov. 2 3 , 1 9 1 1 .) I t is sa id th a t in
one S ta te th e board o f h e a lth requires h a ir shipp ed in to th e S ta te to be subm itted to a
tem p era tu re o f 2 0 0 ° F ., bu t th is rep ort could n o t be verified.




A N T H R A X AS A N O CCU PATIO N AL DISEASE.

105

Precautions for obviating the danger of anthrax from imported
animal materials were first taken h j Congress in 1866. In that year
the same Congress which had limited the importation of cattle as
already described amended the law to apply as well to the “ hides of
neat cattle.” 1 Incorporated in the original statute which it extended,
this amendment also has come down to the present time as part of
the tariff law. While the Department of Agriculture, as stated, has
taken over the regulation o f live-stock importations, the Treasury
Department still has charge of the regulation of hide imports, the
actual administration of both sets of rules, however, being performed
by the Quarantine Division of the Bureau of Animal Industry.
The tariff clause under discussion, however, provides only for the
unregulated entry or the absolute exclusion of hides from suspected
areas, and is therefore likely in application to be either too lax or
too strict. More precise safeguards against anthrax were needed,
and are now authorized by section 2 of the act of February 2, 1903.2
This section empowers the Secretary of Agriculture to take meas­
ures against the introduction of contagious diseases of animals from
a foreign country into the United States or from one State o f the
United States into another. In pursuance of this act the Secretary
of Agriculture has at various times made recommendations for the
disinfection of imported hides, with special care against anthrax,
and rules embodying these recommendations have been issued by the
Division o f Customs of the Treasury Department.
The rules in force during 1916 were based on an order which went
into effect June 1, 1910.3 It required that untanned hides of neat
cattle (later interpreted to include buffalo4), hide cuttings or par­
ings, and glue stock, shipped from districts where anthrax was known
to the American consul to be prevalent, undergo disinfection by im­
mersion for at least 30 minutes in a 1 to 1,000 solution o f bichloride of
mercury. Consuls in such districts were instructed to refuse the
certification of invoices covering the above products for shipment to
this country unless they were disinfected by the prescribed method,
and admission was refused to products requiring disinfection which
lacked the proper certificate. Disinfection of suspected products on
the dock upon arrival in this country or their transportation across
American territory was not permitted, as it might tend to propa­
gate the disease in this country. Disinfection was also required
for hides produced in North America if landed and transshipped in
another country in the course of importation. The rules did not
1 U n ited S ta te s, S ta tu te s a t L arge, V ol. X IV , p. 3.
2 U n ited S ta te s, 3 2 S ta t., 7 9 1 .
8 T rea su ry d ecisio n 3 0 5 8 3 , M ay 2, 1 9 1 0 . A lso kn ow n as T reasu ry D ep a rtm en t C ircu lar
No. 2 3 (D iv isio n o f C u sto m s).
4 T rea su ry d ec isio n 3 1 9 8 1 , N ov. 2, 1 9 1 1 .




106

BU LLETIN OF THE BUEEAU OF LABOE STATISTICS.

apply, however, to goatskins, sheepskins, or articles manufactured
from the hides o f neat cattle.
The delay and expense necessitated by even these mild regulations
caused considerable opposition among American importers, which
may have been increased by the cutting off, through the war, of
hide importations from Europe, especially from Russia, and the
consequent augmentation o f imports from more dangerous sources,
such as China. Moreover, tests seemed to show that soaking in
bichloride of mercury solution of the prescribed strength for so
brief a period as half an hour was totally insufficient to exterminate
anthrax spores.1
Accordingly, late in 1915, the regulations were modified2 to permit
the substitution of either o f two methods of disinfection which ex­
periment had indicated were more efficacious. One of these was
immersion for not less than 48 hours in a solution containing 10
per cent o f sodium chloride (common salt) and 2 per cent of hydro­
chloric acid in w^ater; the other was immersion for not less than 24
hours in a solution containing 2,500 parts o f a 1 per cent formic
acid solution and 1 part of mercuric chloride.3 The Secretary of
Agriculture, according to the order, stated that “ these methods of
disinfection for anthrax hides or anthrax suspected hides will be
acceptable to his department.”
In a little over four months, however, another amendment to the
regulations was issued which, as far as anthrax is concerned, almost
completely frustrated their purpose. This remarkable amendment4
provided that “ in future when a shipment of hides which requires
* * * a certificate of disinfection arrives without such certificate ”
the importer might apply for permission to perform the disinfection
at his tannery. I f the importer had “ proper facilities ” the Depart­
ment o f Agriculture was to permit the disinfection under supervision
o f an inspector from the Bureau of Animal Industry, and the cus­
toms collector, upon being so advised, “ shall permit the hides to go
forward from the port of entry to the tannery under customs seals,”
notification of his action being sent to the inspector who is to super­
vise the disinfection.
It has been seen, however, that in almost every group o f cases
studied most o f the tannery workers contracting anthrax did so in
the early processes of trucking the hides to the tannery, receiving,
checking, sorting, and storing them. Another striking revelation is
the large proportion of cases among longshoremen, teamsters, and
other baggage handlers, including even a Government weigher at­
1 See p. 138.
2 Treasury decision 35761, Oct. 11, 1915.




3 The same as bichloride of mercury.
4 Treasury decision 36188, Feb. 25, 1916.

A N T H R A X AS A N O CCU PATIO N AL DISEASE.

107

tached to the customhouse.1 In view o f these facts, it would seem
that permitting suspected materials to arrive in America and to
spread contagion in their wake from dock to railroad, from railroad
to dray, and from dray to warehouse and tannery before they were
finally disinfected was a violation of elemental principles of caution
and sanitation.
Nevertheless, the Agriculture and the Treasury Departments con­
tinued to weaken their requirements. Under date of April 20, 1916,
still another modification2 was promulgated, setting forth that there­
after even “ foreign hides which can not be certified by an American
consul as coming from a district in which * * * anthrax is not
prevalent” were to be allowed the right o f shipment. The only
restriction was that the bales must “ have been whitewashed under
consular supervision,” and that they were “ subject to disinfection
after arrival at destination in this country.” The provisions for
supervising the disinfection at destination remained the same as
before, but the process was made more thorough, immersion in a
1 to 1,000 solution of bichloride o f mercury for at least 48 hours
being now required. While this rule extended a measure of protec­
tion to tannery workers in the later processes which even the original
requirement o f disinfection for 30 minutes did not afford, it still
left transportation workers and those engaged in receiving the
hides at the tanneries exposed to the full hazard of the disease.
However, even the prescribed method of disinfection was not always
sufficient to destroy the anthrax spore. Moreover, there were serious
difficulties in the way of enforcement, since the consuls, who were to
require the whitewashing of hides coining from anthrax-infected
districts, did not always possess sufficient information as to the loca­
tion of the outbreaks. This source of danger was pointed out as early
as 1897. “ Some o f these officers (consuls) have frankly stated that
the regulations for the disinfection of hides were not and could not
be enforced by them.” 3
Under these circumstances the increasing number of anthrax cases
continued to force attention, and in the fall of 1916 a special commit­
tee of the National Association of Tanners cooperated with the
Federal authorities in the preparation of more effective provisions
for the disinfection of imported hides.4 Under the new regulations
the importation of hides, wool, glue stock, or other products from
animals affected with anthrax is prohibited. For hides from
anthrax-infested districts the 30 minutes’ immersion in 1 to 1,000
1 S ee fa ta l ca se No. I l l , p. 81.
2 T rea su ry d ecisio n 3 6 3 3 2 , Apr. 2 0 , 1 9 1 6 .
3 D e la w a re C ollege A g r icu ltu r a l E x p e rim e n t S t a t io n : A n th rax, A S tu d y o f N a tio n a l
a n d o f S ta te L e g isla tio n on T h is Su bject, B ul. No. X X X V II, 1 8 9 8 .
4 N ow issu ed a s U n ited S ta te s T rea su ry D e p a r tm e n t an d D e p a r tm e n t o f A g r icu ltu r e
J o in t Order No. 2, effectiv e Jan. 1, 1 9 1 8 .
(S e e A ppend ix A .)




108

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

bichloride of mercury solution allowed at the port of shipment is
extended to 24 hours’ immersion. Materials shipped without disin­
fection and without a consular certificate showing nonprevalence of
anthrax may still be received in this country and transported, under
customs seals, to the tannery, where they are to be disinfected under
supervision o f an agent of the Bureau of Animal Industry at the
tannery’s expense. The previous method of disinfection at the
tannery, namely, soaking for not less than 48 hours in a 1 to 1,000
bichloride o f mercury solution, is still accepted, but as a substitute
hides may be immersed for not less than six days in a 1 to 5,000
bichloride o f mercury solution, followed by not less than 5 days in
lime of the usual strength for dehairing, which is believed by the
bureau effectively to disinfect hides against anthrax.1 The new
regulations also contain for the first time detailed requirements for
.the disinfection of glue stock, bones, hoofs, wool, and hair, and of
cars, boats, other vehicles, and certain premises.2
The growing frequency of anthrax among industrial workers in
New York and Massachusetts during 1915 and the early part o f 1916
stimulated interest in the question among officials of these States.
In New York the industrial commission investigated the reported
cases which developed during the last 10 months of 1915, and called
a conference on the subject for March 27, 1916. Four State depart­
ments were represented— the conservation commission, the depart­
ment of agriculture, the department o f health, and the industrial
commission. The conservation commission reported that in response
to a petition from the residents of one county, who complained o f a
leather factory as the polluting agent, it was studying the relation
o f stream pollution to anthrax. Appointment of a committee of one
representative from each department was suggested for the purpose
o f studying the question thoroughly. Recommendations later issued
by the division of industrial hygiene of the industrial commission
are reprinted in Appendix A.
In Massachusetts the occurrence, early in .1916, o f 25 cases, at least
four o f which were fatal, and which centered among the tannery
workers at Woburn and Winchester, started an investigation by the
State department of health, with the cooperation o f the board of
labor and industries. Investigators were sent to near-by States to
trace the suspected shipments of hides to their source and to learn
whether cases had been caused by them elsewhere. It was found
that 20 o f the cases were infected from one source, a cargo o f dried
hides from China.3 Rules subsequently suggested by the State board
o f labor and industries for the handling of hides, skins, and wool
are reprinted in Appendix A.
1 See p. 140.
2 See Appendix A.
3 United States Public H ealth Reports, Dec. 15, 1916, pp. 3399-3402.




A N T H R A X AS A N O CCU PATIO N AL DISEASE.

109

COM PENSATION.

Also, in the matter o f workmen’s compensation for victims of oc­
cupational anthrax the United States has made but little progress—
much less than other leading countries. While Great Britain, Ger­
many, France, Holland, Italy, South Australia, and the Canadian
Province of Ontario have for years been awarding such compensa­
tion, in the United States only one State is as yet acting consistently
on this principle.
The Massachusetts workmen’s compensation law, when it was
drafted, was made to cover “ personal injury,” instead of merely
“ personal injury by accident” as did most of the other State laws.
Occupational diseases were thus included, and during the first three
years of the operation of the act, closing June 30, 1915, there were
filed with the industrial accident board 30 claims for compensation
on account o f occupational anthrax, in 17 of which awards were
made.
8 .—CLAIMS FOR COM PENSATION ON ACCOUNT OF A N T H R A X FIL E D U N D E R
T H E M ASSACHUSETTS W O R K M E N ’S COM PENSATION LAW , 3 Y E A R S E N D IN G JU N E
30, 1915.

T a b le

Compensation.
Occupation.

D uration of
disability.

Indem nity for wage loss.

Medical aid.

HIDE AND SKIN WORKERS.
_ None d u e....................................... N ot reported.
Lumper in beam house..................... No disability_
1 w eek................ ....... d o.............................................
Beams ter.............................................
Do.
Machine operator in beam house--- I f w eeks............. ....... d o.............................................
Do.
Do.
L um per............................................... If w eeks............. ....... d o .............................................
Do.
Lumper in dry lo ft............................ 2f w eeks............. $2.86...............................................
Do.
Lumper in storehouse....................... 2 f w eeks............. $2.57...............................................
Do.
Lumper in beam house..................... 2f w eeks............. $5.43...............................................
Do.
Tanner................................................. 3 w eeks............... N ot reported.................................
Do.
Do ............................................... 3 f w eeks............. ....... d o .............................................
Do.
Do
.......................................... 4 w eeks............... ....... d o.............................................
Leather finisher doing “ seasoning” . 5f w eeks............. $14.28............................................. $5.00.
...................................... Not reported.
Foreman in rough stock departm ent. 6 w eeks............... $18.00
Do.
Laborer in leather factory................. ....... do................. $16.00.............................................
Do.
Tanner
...................................... 6f w eeks............. N ot reported.................................
Do.
L um per............................................... 7 w eeks............... $21.43.............................................
Do.
Splitter of skins in leather factory... 7f w eeks............. $23.79.............................................
Do.
Lumper in coloring room of a calf­ F a ta l.................. Unable to locate dependents in
Europe.
skin tannery.
Do.
Worker in soaks in beam house....... ....... d o................. ....... do.............................................
TRANSPORTATION WORKERS.

Longshoreman....................................
Do
........................................
Do
............................
Do
...................................
Do
......................................
Do ..............................................
Laborer for private weigher..............
Do
........................................
Do
..................

1 w eek................
3f w eeks.............
5? w eeks.............
6 w eeks...............
8 f w eeks.............

None d u e .......................................
$11.42.............................................
$23.22.............................................
$24.00.............................................
$58.04.............................................
C
1)
7f w eeks............. $34.46.............................................
15 w eeks............. $78.00.............................................
15 ^ w eeks........... $110.86............................................

Do.
Do.
$16.00.
N ot reported.
Do.
0)
N ot reported.
$56.00.
$1.00.

WOOL AND HAIR WORKERS.

Foreman wool-pulling departm ent.. 2 w eeks............... None d u e....................................... $9.50.
Picker hand in felt factory................ I lf w eeks........... $83.84............................................. Not reported.
Over 2 years; $754.69............................................ $18.29.
Brush drawer in brush factory
exact time not
reported.




i Compensation refused.

110

B U L L E T IN OF T H E BU BEA U OF LABOR STATISTICS.

Hide and skin workers made up over one-half of the claimants,
or 18 out o f the 30. O f these, seven were “ lumpers ” in leather fac­
tories, six o f whom were- employed in one establishment in Salem.
One was a foreman in the “ rough stock ” department in a goat and
sheepskin tannery; one was splitting skins in a leather factory; one
was a leather finisher engaged in “ seasoning ”—he applied finish to
skins with a sponge, and an “ eruption on both his hands and fore­
arms ” is reported. One tannery employee worked in “ soaks in beam
house” ; there were also a “ machine operator in beam house,” a
“ beamster,” and a laborer, all employed in leather factories. In four
cases it was merely stated the 6 men worked in tanneries.”
4
Transportation workers were represented by nine claimants. Six
of these were longshoremen, of whom five were employed by one
concern in Boston. One was, by his own testimony, on or about July
24, “ discharging buffalo hides from a steamship. I had been on this
job four days when I got a scratch on my arm. The following day
I noticed something l-ike a wart which was itchy. I finished the job
and there was no work until August 5. I started to go to work on
this day, but my arm was itchy and sore, and I went to the hospital
instead, where they said I had anthrax, and was operated on right
away.” Another of the longshoremen “ had been pushing behind
truck unloading hides for three days, and he stopped work at the end
of the third day, as his hands began to swell ” ; two were “ handling
salt hides,” and one “ green ” hides, at the time they contracted an­
thrax; the sixth was unloading wool and hides, in addition to other
cargo. The remaining three transportation workers were reported as
“ laborers,” all employed by a firm of weighers in Boston.
Two cases occurred among woolworkers; one was a foreman in the
wool-pulling department o f an establishment where wool was pulled
and scoured; the other was a “ picker hand ” in a felt factory. The
report reads: “ Sliver ran into his leg. It was removed and leg was
poisoned from wool. Anthrax and complications on left lower ex­
tremity.”
One applicant for compensation was a brush drawer. She scratched
her face over the left eye, and as a result anthrax developed.
The periods of disability ranged from one week to over two years.
In one case no disability resulted and the employee remained at
work; five workers were disabled from one to two weeks. In none
of these six cases was compensation awarded, as the law requires a
waiting period of two weeks. Medical aid is allowed by the Massa­
chusetts law from the day of disability, but in only one o f these six
cases was it stated that such aid was given. In the remaining cases
disability lasted beyond two weeks, and 17 awards for compensation,
beginning with the third week and equal to two-thirds of average
weekly wages, were made. The amounts ranged from $2.57 for a




AN TH RAX AS AN OCCUPATIONAL DISEASE.

Ill

disability of two and two-sevenths weeks to $754.69 for a disability
o f over two years. This case was finally disposed of by a lump-sum
payment toward the close o f the second year of weekly payments.
In addition to the weekly indemnity for loss o f wages, medical
.attendance costing from $1 to $56 was paid for in at least six cases.
Three o f the claims were filed in behalf o f workers whose anthrax
attacks ended fatally, the course of the disease being extremely rapid
in all three instances. Two o f the victims were taken to a hospital
two days after they began to feel i l l ; one died in five hours and the
other in IT hours after admission. In neither o f these cases was
compensation paid, as it was impossible to locate the dependents in
Europe. In the third fatal case, in which death occurred three days
after admission to the hospital, the claim for compensation filed by
the victim’s mother was disallowed by the arbitration committee to
which it was referred: While there was no question as to the cause
of death? the insurer contended that the disease was not contracted
while the deceased was in the employ o f their policyholder, but while
working for another company Twhich was not insured under the act.
One-third (10) o f the cases considered in this section occurred in
Boston. Six were from Salem; Haverhill, Peabody, and Lynn fur­
nished each two cases; Worcester, Davenport, Millbury, and Woburn,
one case each; in the remaining four cases the place o f employment
could not be ascertained. Only one of those injured was a woman.
The youngest was 17 years old; one-half7 or 15, were between the
ages o f 20 and 29, eight were between 30 and 39, five between 40 and
49, and one was 60 years o f age.
Most frequently, or in nine cases, the lesions were on the face. In
seven they were on the hand or arm ; five workers, o f whom one died,
had the pustule on the neck; one, who died, had it on the chest, and
one on the leg. In the seven other cases the location of the lesion was
not stated; one o f these, however, elided fatally and, judging by the
symptoms, it was probably a case of internal anthrax. The cause o f
death was given as “ lobar pneumonia,” and for this reason the case
was not listed among those reported in the United States registration
area. Nevertheless, a blood smear sent to Harvard Medical School
showed the presence o f anthrax bacilli.1
Another State which has taken the same enlightened position as
Massachusetts is California. The compensation statute o f this west­
ern Commonwealth applied, as enacted, only to “ personal injury
sustained * * * by accident.” By amendment m 1915 the words
“ by accident ” were stricken out, so that the law is now as broad
1
In fo r m a tio n fo r su b seq u en t m o n th s sh o w s th e num ber o f M a ssa c h u se tts a n th r a x c laim s
n o tice a b ly in crea sed . In th e sin g le y ear en d in g J u n e 30, 1 9 1 7 , fo r in sta n ce , th ere w ere
2 3 claim s. No co m p en sa tio n w a s p a id in 5 o f th e se cases-; in th e o th ers aw ards w ere
m ade r a n g in g from $ 9 .1 4 fo r 1 8 d a y s’ d isa b ility to $ 5 2 1 .2 3 fo r 3 6 5 d a y s’ d isa b ility .
T here w ere no d e a th cla im s.




112

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

in scope as that of Massachusetts. Up to May 1, 1916, however,
no claim for anthrax had been presented to the industrial accident
commission, so that the first California award for this trade illness
had still to be made. In 1915, also, Pennsylvania amended its
constitution to allow the passage of a law establishing compensa­
tion for occupational diseases, but the legislature o f 1917 did not
utilize its opportunity to enact the necessary legislation.
The compensation laws of the remaining States do not cover dis­
eases o f occupation. Nevertheless in a certain number of cases in­
demnity for anthrax has been allowed when infection developed as a
result o f an accidental injury sustained by the worker in the course
o f employment.
In New York, for instance, five such claims were filed during the
first 22 months o f the operation o f the act (July 1, 1914, to May 1,
1916). On the first claim to be presented in New York, the commis­
sion awarded seven and five-sixths weeks’ compensation. The insur­
ance company took an appeal, but later withdrew it and paid the
claim. The workman concerned, an employee in a plant where raw
skins are handled, was trimming sheepskins on the day o f the acci­
dent. He hit his jaw against the beam on which he was placing
skins for the purpose o f cutting off the head, tail, and legs. The ac­
cident occurred in the forenoon and caused an abrasion of the skin,
with pain and smarting, so that during the afternoon the claimant
frequently rubbed the sore place with his hand. On the next day a
doctor was called in, found a pustule at the seat o f the injury, and
diagnosed the case as anthrax. The commission decided that the in­
jury “ was an accidental injury, and arose out o f and in the course
of his employment.” The insurance carrier made the contention
that anthrax is an occupational disease in tanning, and that there­
fore it was not under the compensation act. However, the courts
have sustained the commission-in a number of cases, thus establish­
ing a favorable precedent for New York State.
In one o f these,1 the court among other things said:
There is a broad distinction between the present case and the case o f an
occupational disease. The latter is incidental to the occupation or is a natural
outcome thereof. It is expected, usual and ordinary. This disease incurred
by the claim ant was unexpected, unusual and extra ord in a ry ; as much so as if
a serpent concealed in the hides had attacked him. There is no difference in
principle because the attack instead o f being made unexpectedly by a con­
cealed serpent was made unexpectedly by a concealed disease germ. There
seems to be no question in this case but that the claimant contracted the
disease in the manner and under the conditions above indicated. W e think
the circum stances constitute an accidental injury within the meaning o f the
statute.
1 Hiers v. Hull & Co., 178 N. Y . App. Div. 350, May 2, 1917.




A N T H R A X AS AN O CCU PATIO N AL DISEASE.

113

However, there is another theory on which this award may be upheld. The
claim ant in the course o f his employment and as a result thereof had received
an abrasion on his hand or a fissure therein. This may properly be deemed an
accidental injury arising out o f and in the course o f his employment and the
disease or infection caused by the anthrax germ may be deemed such disease
or infection as may naturally and unavoidably result from such in ju ry within
the meaning o f the statute.

The situation in New Jersey is the same as that in New York.
Records o f the* employers’ liability commission in that State for the
year 1915 reveal four cases in which “ there was previously a specific
accident which later became infected (anthrax).” In three cases
the employees were working on hides and skins; the occupation o f
the fourth worker is not given; it is merely stated that he was in­
jured on a shearing machine. One was a fatal case; the other em­
ployees were out for three, five and two-sixths, and eight weeks, re­
spectively. The amounts awarded in the fatal case, where there
were no dependents, w^ere $100 for burial and $13 for medical aid.
In the other cases compensation at half the average wages amounted
to $29.17, $16.67, and $36, respectively, and for medical aid $33,
$41.50, and $44 was allowed.
In Pennsylvania the workmen’s compensation law o f 1916, similar
in intent to the laws of New York and New Jersey, provides that “ the
terms 4injury ’ and c personal injury ’ as used in this act shall be
construed to mean only violence to the physical structure o f the body,
and such disease or infection as naturally results therefrom.” When
in April, 1916, a claim was filed with the workmen’s compensation
board on the part of a hair sorter1 who had contracted anthrax,
the claim was disallowed, as the examination o f the physician “ dis­
closed no evidence of any wound or cut upon the person o f the
claimant nor did the investigation, made at this time, discover any
unusual incident or occurrence that had happened to the employee
in the course of his employment. The claimant also admitted that
there had been no wound or other unusual incident.”
I In a later case the Pennsylvania board reversed this narrow atti­
tude and granted a substantial award to the widow o f a tannery
employee. In this matter the board held that, 66 Given the anthrax
germ as a readily distinguishable indentity with definite propor­
tions coming in contact with the human body and gaining an
entrance into the same by means of a break in the texture of the
skin,” such contact was “ in itself violence to the physical structure
of the body.” 2
1 W o r k in g in a ta n n e ry .
2 Yonnkin r. Beggs & Cobbs Tanning Co.
No. 161, p. 89.

141633°— B u ll. 267— 20-------8




For a more extended quotation see case

114

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

In Michigan an award has been made to the widow o f a hide
handler who is believed to have breathed the bacillus in while at
work. The State accident board and the State supreme court decided
that the deceased died o f a compensable accident.1
As far as can be learned no other State has yet been called upon
to decide a compensation claim arising from anthrax, but probably
the outcome would be the same as in New York and New Jersey.
While this would permit indemnity for a limited number of cases—
those resulting from a definite physical wound—such a policy is
far from just. In equity to sufferers from the disease, no less than
from the standpoint o f enlisting the full interest of emploj^ers in
methods o f preventing infection, all cases of occupational anthrax
should be compensated upon the same terms as industrial accidents.
1 D o v e v. A lp en a H id e a n d L ea th e r Co., 1 6 4 N. W. 2 5 3 , 1 9 1 7 .




C H A P T E R

V .

A N T H R A X IN EUROPE.
In Europe, where occupational anthrax has been a matter of public
moment for a much longer period than in the United States, the cam­
paign against it has been pressed with a consistency and vigor not
yet displayed in this country. Among legislators and administrative
officials, no less than among employers and physicians, there has been
keen realization of the dangers o f the scourge and of the urgency o f
measures for its eradication.
PRIVATE ACTIVITY.

The dramatic acuteness and high mortality of anthrax have led
abroad to considerable private activity for its study, cure, and pre­
vention. In England, Germany, France, and Italy influential associ­
ations of manufacturers have interested themselves in the problem,
while scientific societies o f international scope have cooperated in
the campaign.
A N T H R A X INVESTIGATION BOARD FOR BRADFORD AN D DISTRICT.

Since in England the manipulation of dangerous kinds of wool is
practically confined to the West Hiding of Yorkshire, the chamber
o f commerce o f that district, at a joint meeting with representatives
o f labor unions, organized in 1905 the now famous Anthrax Investiga­
tion Board for Bradford and District. The purposes of this organi­
zation are (1) the investigation of anthrax .generally; (2) the more
precise determination of the classes o f wool and hair in connection
with which the danger of anthrax arises; and (3) the discovery of
further means of prevention. The investigation is carried on
through inquiries into cases of anthrax, and samples are collected of
the material causing the infection. The data thus obtained are
brought to the knowledge of the manufacturers. The board has en­
gaged the services of a bacteriologist, some o f whose duties are
(1) the examination o f material which has caused outbreaks of
anthrax; (2) systematic examination of samples irrespective o f any
such outbreaks; (3) studying of the part played in infection by the
sand, dirt, and organisms present in the material; (4) verification of
doubtful cases and examination o f material submitted by physicians.
Particularly careful study is given to the urgent question of disin­
fecting raw wool, and especially to the removal of blood clots and
bloodstained fibers, which are frequent carriers of spores.




115

116

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

In order to secure effective results a large and representative mem­
bership was considered necessary. The board is therefore composed,
in addition to the bacteriologist, the honorary consulting chemist,
and the secretary, of 18 members, elected annually from among the
manufacturers, the members of the Bradford Chamber of Commerce,
and the health committee o f the Bradford City Council; occasionally
representatives of organized labor are included. The activity of the
board is made possible chiefly by private contributions, the majority
o f contributors being employers, although labor organizations and
occasionally private individuals also subscribe. A point deserving
special mention is the annual subvention of $250 granted for several
years by the Home Office^ which in 1913 was raised to $500.
T o obtain the highest possible degree of efficiency the board is con­
stantly seeking the cooperation of the medical profession. Circulars
are distributed inviting physicians to send in information of each
case o f suspected anthrax, together with serum or blood for examina­
tion. The board emphasizes the necessity of speedy action in sus­
pected cases and urges particular care with regard to bloodstained
materials. Its statistics, which will be discussed later, are excellent,
and the educational propaganda which it carries on is undoubtedly
an important factor in the antianthrax campaign.
GERMAN EMPLOYERS* M U TU A L TRADE ASSOCIATIONS.

The activity of the German manufacturers has taken an entirely
different form. In Germany preventive measures are introduced
by the employers’ mutual trade associations ( B e r u f s g e n o s s e n s c h a f t e n )
in those trades where the danger of anthrax is present. These asso­
ciations are organized primarily for the purpose of carrying mutual
workmen’s compensation insurance. Since it is to their financial ad­
vantage to have as few industrial accidents as possible, the activity
o f these associations is remarkably effective, aiming at the pre­
vention of both industrial accidents and diseases. The employ­
ers of practically all industries have combined into such associations
and, as anthrax is compensated as an industrial injury, the
associations for the leather, wool, hair, and brush industries have
set forth carefully worked out rules based on the latest achieve­
ments of technical and sanitary science. These rules when officially
indorsed have the force of law. A considerable incentive to the ob­
servance o f these rules is provided in the cleverly arranged sliding
scale o f premiums required from the employer and based on the
number and effectiveness of safeguards introduced in his factory;
that is, the more attention is paid to disease and accident prevention,
the lower are the insurance premiums charged the owner of the
establishment.




A N T H R A X AS A N O CCU PATIO N AL DISEASE.

117

The employers conduct the accident insurance activity of the trade
associations, but in order to elicit the fullest cooperation of the
workers they have given the latter a voice in framing the safety
and sanitation rules; they have gone even further and have made
the workers responsible for compliance with those rules which con­
cern them. The value o f personal appeal has also been appreciated
by these associations; they have addressed warnings to the workers
instructing them in the dangers and urging precaution. The remark­
able thoroughness with which these employers’ mutual associations
have carried out their tasks has placed them in the foreground as
powerful factors in the promotion of industrial health and safety.
ASSOCIATION OF FRENCH M ANUFACTURERS FOR THE PR EVENTION OF INDUS­
TRIAL ACCIDENTS.

The idea o f employers’ mutual organization for the purpose of
accident prevention has found application in other countries also. In
France in 1883 the manufacturers combined into the “ Association
des industrials de France contre les accidents du travail,” which by
a Government order'was recognized in 1891 as a public service or­
ganization (Etablissement dPutilite publique).1 This association pub­
lishes instructions to workers similar to those issued by the Home
Office in England and by the German trade associations, and re­
quires that they be posted in work places where the danger of anthrax
is present.
M IL AN LABOR CLINIC AND OTHER PR IVATE AC T IVITY IN IT A L Y .

In 1910 the celebrated Labor Clinic at Milan, the first of its kind
in the world, was established by a group of socially minded medical
men 4 for the scientific study and prevention of occupational dis­
6
eases.” In cooperation with the Permanent International Commis­
sion for the Study o f Occupational Diseases, which has its head­
quarters in the same city, the clinic has issued sanitary regulations
and is carrying on an educational propaganda among workers and
employers in the industries which involve exposure to anthrax.
There exists in Italy also the Industrial Employers’ Association for
the Prevention of Industrial Accidents (Associazione degli Industriali per prevenire gli Infortuni del Lavoro), an organization very
similar to the French association which has already been described.
This body issues instructions for workers, and also publishes occa­
sional studies on occupational anthrax.
A notable instance of self-imposed but rigidly observed regula­
tions is found in the hair works of Carlo Pachetti & Co., at Pavia.
This is the largest establishment of its kind in Italy, and it re­
ceives practical^ all the hair imported. The firm is equipped with
1 W alter Abelsdorff: Gewerbliche Milzbrandvergiftungen in Deutschland, Frp.nkreich,
England, und Holland, 1915, p. 7.




118

B U L L E T IN OF T H E B U REA U OF LABOR STATISTICS.

all the requisites of modern industrial hygiene, and has adopted the
most advanced measures for the prevention of anthrax. Each
process is carefully regulated. The hair is disinfected; great care is
given to ventilation, cleanliness, and the elimination o f dust; and
medical supervision o f the highest order is instituted, even a bac­
teriological laboratory being provided and a supply of the Sclavo
serum being kept. The proprietor states that cases of anthrax are
detected in the earlier stages and promptly treated, and that the
patients usually recover 66 without cessation of work for more than
a day or two.” 1
IN T E R N A T IO N A L O RG AN IZATIO N S AND CO N G R ESSES.

Anthrax has also been carefully studied outside o f industry.
Besides the Permanent International Commission for the Study of
Occupational Diseases, already mentioned, both international con­
gresses on occupational diseases which have so far taken place, one
at Milan in 1906 and the other at Brussels in 1910, have discussed the
subject. More prominence was given to it on the program o f the
proposed third congress on occupational diseases, which was scheduled
for Vienna in 1914 but was postponed on account of the war. In that
congress, papers were to be read by such authorities as Dr. Legge
o f England, Cavaille o f France, and Dr. Holtzmann of Germany.
Keen interest is also taken in the subject by the International Asso­
ciation for Labor Legislation, o f which the American Association for
Labor Legislation is an active branch. At the seventh delegates’
meeting of the international body, which took place in Zurich Sep­
tember 10 to 12, 1912, a subcommittee was appointed for the study
of occupational anthrax, the recommendations of which will be found
in the concluding part of this report. The subject was also on the
program o f the eighth delegates’ meeting, which was expected to
meet in Bern September 14 to 17, 1914.
GOVERNMENTAL INVESTIGATIONS.

Probably the first official investigation of anthrax was made in
1842 in France. In that country severe epidemics of the disease
among animals in certain districts and its consequent frequency
among human beings had led to these areas being called “ champs
maudits,” or cursed fields. The investigation was undertaken at a
time when medical science was rather primitive, and antedated by
eight years the discovery o f the bacterium. Hence it did not bring
forth any considerable results, but the interest of the Government is
significant. In later years the question of anthrax was taken up by
a commission on industrial hygiene organized under the Ministry o f
Labor.
1 See C. II. W . P a g e : British Industrial Anthrax, in Journal of Hygiene, December,
1909, p. 373.




119

A N T H R A X AS A N O CC U P A TIO N A L DISEASE.

In England the initiative against anthrax was taken by Parlia­
ment, where this subject was considered as early as 1878. In the
year 1880 the Government, alarmed by the large number o f cases
among workers, appointed a commission to study the situation. In
1893 another official investigation was undertaken. These efforts,
however, did not solve the problem, and in the year 1913 the Home
Office considered it necessary to appoint a departmental committee
for the purpose of investigating anthrax in the textile industries.
In Germany the Government was stirred by the alarming propor­
tions which the disease assumed in the hair factories o f Nuremberg
and in 1894 an investigation was ordered all over the Empire.
Inquiries on a more limited scale had been made as early as 1875.
In Belgium anthrax has been a familiar subject fo r many years,
but it was not until 1900 that Government interest became active.
At that time several cases occurred in an important tannery and the
Government ordered the medical factory inspectors to make an
investigation, which, at first limited to skin and hair industries, was
afterwards extended to all other occupations subject to the danger
o f anthrax.
Moved to action by the number o f anthrax eases reported in the
tanning industry under the accident compensation law of 1301, the
general director o f labor in Holland also ordered a painstaking
investigation of that industry, the report o f which was published in
1913.1
SYSTEMATIC REPORTING AND RESULTANT DATA.

Illuminating as are most of the studies just mentioned, they cover
only limited periods, and emphasize the necessity for more thorough,
continuous collection of data. This has been sought in various coun­
tries, usually through the enactment of compulsory reporting laws.
GREAT BR ITAIN .

Apparently the earliest requirement concerning the reporting o f
anthrax as an occupational disease is found in section 29 of the Brit­
ish Factory and Workshop Act of 1895,2 later superseded by the
similar law of 1901.3 Section 73 of the latter act, referring to dan­
gerous and unheaithful industries, requires every medical practitioner
called in to visit a patient suffering from lead, phosphorus, arsenic,
or mercury poisoning, or anthrax, contracted in a factory or work­
shop, to report the case to the chief inspector of factories at the Home
Office, London. For every notice sent, the physician receives a fee
o f 2s. 6d. (61 cents), while failure to comply with the law makes
him liable to a fine of not over 40s. ($9.73). Similarly the manager
or owner o f the factory must report every case o f any of the above1 Directie van den Arbeid.
2 57 and 58 Viet., ch. 37.
s 1 Edw. V II, ch. 22.




De Looinijverheid in Nederland, The Hague.

1913.

120

B U L L E T IN OF T H E BU REAU OF LABOR STATISTICS.

mentioned diseases to the inspector and to the certifying surgeon for the
district. Upon receipt of the report the latter must visit the patient
and the place where the case occurred and report to the chief inspector.
The report by the factory management must cover the following
points :
1. Name o f establishment.
2. Name and address o f proprietor.
3. Kind o f work done.
4. Nature o f the disease.
5. Name and address o f the patient.
6. Age and sex.
7. Precise statement as to occupation.
In the report o f the factory inspector to the Home Office, which
must be sent within seven days after receipt of the report from the
certifying surgeon, the sorts o f suspected wool, hair, bristles, hides,
or skins must be stated, as well as the country o f origin.
For the first few years but a small number o f cases was reported—
only 114, for instance, for the years 1896 to 1899, inclusive. Since
that date reporting has been more complete, and larger numbers of
cases have been brought to official attention.
The following table is compiled from the annual reports of the
chief factory inspector o f Great Britain and shows the number o f
cases o f anthrax reported to that official for the years 1900 to 1918
and the number o f these cases which were fatal:
9 . — C A SE S OF A N T H R A X A N D N U M B E R OF D E A T H S T H E R E F R O M R E ­
P O R T E D TO C H IE F FA C TO R Y IN S P E C T O R OF G R E A T B R IT A IN , 1 9 0 0 TO 1 9 1 8 ,
B Y IN D U S T R IE S A N D Y E A R S.

T able

[Source: Seventeenth Abstract of Labor Statistics of the United Kingdom, 1915, pp. 124, 125; Thirteenth
Annual Report, Anthrax Investigation Board for Bradford and District, 1918, p. 23.]
Wool industry.
Year.

Skins and
hides.

Horsehair.

Total.

Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
re­
re­
re­
re­
re­
re­
re­
re­
re­
re­
ported. ported. ported. ported. ported. ported. ported. ported. ported. ported.

1900..............................
1901..............................
1902 ............................
1903..............................
1904..............................
1905..............................
1906..............................
1907..............................
1908..............................
1909..............................
1910..............................
1911..............................
1912............................
1913............................
1914..........................
1915............................
1916 ............................
1917..............................
1918 1

9
6
12
20
12
34
24
23
18
28
28
35
31
43
26
27
79
57
40

2
4
2
5
1
12
8
3
3
3
3
10
6
4
5
3
10
8
3

12
9
10
7
12
7
10
17
10
8
6
8
7
5
5
2
6
3
4

3
1
2
1
4
1
5
4

Total................

552

95

148




Other
industries.

1
5
5
1
3
4
5
2
1
6
3

3
1
2

9
20
11
12
18
17
18
12
13
18
14
20
8
19
15
18
18
29
14

32

303

49

2
1
1
1

1 Ten m onths.

2
1
4
3
2
1

7
4
5
8
8
1
14
6
6
2
3
1
1
3
8
3
2
4
86

1
5
2
1
3
2
3
1
2

1
1
1
23

37
39
38
47
50
59
66
58
47
56
51
64
47
70
54
50
105
- 93
58

7
10
9
12
10
18
21
11
7
12
9
11
6
7
7
8
16
12
6

1,089

199

A N T H R A X AS A N OCCU PATIO N AL DISEASE.

121

These data show a marked though irregular increase in the number
of cases reported, which appears rather unexpected in view of the
several preventive measures introduced during that period. The
increase, however, may be due not to the lack or ineffectiveness of
protective legislation, but to more extensive use of dangerous mate­
rials or to a more satisfactory compliance with the notification law.
Probably the fact that the TVorkmen’s Compensation Act of 19061
made anthrax a compensable disease has had much to do with
securing fuller reports. As will be seen from the table, the frequency
of anthrax varies considerably in the different industries. It is
significant that in 11 of the 14 years for which the data are given
the largest number of cases occurred in the wool industry, which is
more developed in England than any o f the other industries subject
to anthrax. In 6 of these 11 years, also^ one-half or more of the total
cases of anthrax reported each year occurred in that industry. Next
in the prevalence of anthrax is the leather industry. Practically
all industrial cases of the disease occur among workers in the wool
and leather industries and in animal-hair works; in the remaining
occupations anthrax is less frequent.
An important element in anthrax statistics is the death rate. A
high rate may mean absence of curative measures, or it may mean
lack o f familiarity with the symptoms of the disease, w hich prevents
T
early diagnosis and postpones treatment to a stage when cure is no
longer possible. The death rate for the seven years 1900 to 1906 was
25.9 per 100 cases; but a marked improvement took place in the
subsequent similar period, when it was only 16 per cent.
More detailed statistics are available for the wool industry of the
West Riding of Yorkshire, which is under the supervision o f the
anthrax investigation board organized for that district. The fol­
lowing table illustrates the situation in that industry:
1 0 .—CASES OF A N T H R A X IN T H E W O O L IN D U S T R Y R E P O R TE D TO T H E AN ­
T H R A X IN VESTIG ATIO N BO AR D FOR B R A D F O R D A N D DISTRICT, 1906 TO 1914.

T able

[Compiled from annual reports of the Anthrax Investigation Board for Bradford and District.]




Cases reported.
Year ending
Oct. 31—
External. Internal.
1907...............
1908...............
1909...............
1910...............
1911...............
1912...............
1913...............
1914...............
1915...............

11
8
17
12
14
15
20
18
14

Total. . .

129

1
2
1

Total.

Deaths
reported.

2

12
10
18
12
19
18
21
18
16

3
3
2
1
8
5
3
5
2

15

144

32

5
3
1

* 6 Edw. V II , ch. 47, third schedule.

122

B U L L E T IN OF T H E B U BEA U OF LABOR STA TIST IC S.

Comparison of these data with the data for the wool industry of
the whole country for the almost exactly corresponding period of
1906 to 1913 shows that more than one-half of the anthrax cases in
this industry occur in the district o f the West Riding. The high fre­
quency o f anthrax in that district is caused by the use o f wool im­
ported from such countries as Persia, Turkey, India, and Russia,
where anthrax is endemic and where very little or no attention is
given to the requirements of hygiene.
GERM ANY.

In another leading European country, Germany, where consider­
able attention is being given to the subject of anthrax, fairly com­
plete data are obtainable, but only for the last few years. For the
years 1894 to 1903 admittedly incomplete statistics are reported by
Dr. Legge.1 He states that in that period there were 901 cases of
anthrax, including those in agriculture as well as in manufacturing,
o f which 128 were fatal.
A great improvement in the collection of information was brought
about in 1910, when an order of the Federal Council went into effect,
extending to anthrax the notification and other provisions of the
act o f 1900 relative to diseases constituting a public menace.
Besides the usual data as to name, sex, age, address, and occupa­
tion, the following information, important from the medical point of
view, must be given:
1. Date when taken ill.
2. Date o f first medical treatment.
3. Date o f admission to a hospital.
4. Date when the disease was diagnosed by the doctor as anthrax.
5. Was the disease bacteriologically recognized as anthrax ? When ?
B y whom?
6. Nature of the disease: Anthrax of the lungs, anthrax of the
bowels, anthrax o f the skin? I f anthrax of the skin, what part o f
the body was affected?
7. Has the sick person recovered ? Has he died ? When ?
Even more minutely are taken up the questions o f the patient’s
occupation and of the manner in which infection was transmitted.
The method o f filling out the schedule calls for cooperation between
several governmental agencies, namely, the police authorities, the
district medical man or veterinary surgeon, and the factory inspec­
tor. A duplicate of the filled-in schedule is sent to the authority in­
trusted by the provincial government with its verification. Upon
verification a copy is transmitted to the Imperial Health Office at
Berlin, where it must be received within two weeks of recovery or
death o f the patient.




1 T. M. Legge, in The Lancet, M ar. 18, 1905, p. G92.

123

A N T H R A X AS A N O CCU PATIO N AL DISEASE,

The statistics obtained under this law are published annually and
are of more interest than the English figures because they include all
cases, nonoccupational as well as occupational. Up to the present,
figures are available only for the years 1910 to 1912.
T able 1 1 .—CASES OF A N T H R A X R E P O R TE D TO T H E IM PER IA L H E A L T H OFFICE
OF G E R M A N Y, 1910 TO 1912.
[Compiled from Rieichs-Arbeitsblatt, July, 1914, p. 588.]

1910
Industry.

1912

1911

Cases Deaths Deaths Cases Deaths Deaths Cases Deaths Deaths
report­ report­ per 100 report­ report­ per 100 report­ report­ per 100
cases.
ed.
ed.
ed.
ed.
cases.
ed.
cases.
ed.

Agriculture...............................
Cattle dealers, veterinarians,
and flayers............................
Tannery and other leather
workers..................................
Hair and brush workers........
Wool combing..........................
Miscellaneous...........................

121

103
15
1
9

19
3

9

5

Total occupational.......

263

3G

13.7

201

36

13.8

246

28

11.4

Total anthrax...............

287

40

13.9

281

40

14.2

274

36

13.1

12

142

114

1

17

75
19

2

16

16

14

10
4

10

78
21

i

16 j

1
7
4
6

Taking the cases in the last four groups as those of anthrax in
manufacturing pursuits, we obtain for the year 1910, 128 such cases;
for 1911, 103 cases; and for 1912, 115. A comparison o f the individ­
ual occupations shows that agriculture, followed by the leather in­
dustry, heads the list in each of the three years. The death rate is
somewhat higher than that shown by the English figures (17.6,
17.2, and 12.8) for the corresponding years; it is also higher for
the nonoccupational group than for the occupations, which is true
in other countries also. This is explained by the comparative in­
frequency of nonoccupational anthrax and consequent lack of fa ­
miliarity with the symptoms on the part of the victims and their
physicians.
Owing to the brief period covered by the data no conclusions can*
be drawn as to fluctuations in the prevalence of the disease, but the
situation in*the leather industry is worth noting. The number of
cases dropped from 103 in 1910 to 75 in 1911, and to 78 in 1912.
This was probably due to the effective preventive regulations for
that industry which went into effect in the latter part of 1910.
The distribution by sex of all cases reported in the three years
was as follows:




Year.
1910............
1911............
1912............

Males.
257
264
254

Females.
30
17
20

Total.
287
281
274

124

B U L L E T IN OF T H E BU BEA U OF LABOR STATISTICS.

The small number o f eases among women is explained by their
more limited employment in the occupations subject to anthrax.
FRANCE.

In France, also, anthrax statistics are of a very recent origin.
They are now being collected as a result of the ministerial order of
July 20, 1910, but, as in England, only cases of industrial anthrax
are included. For the years 1910 to 1912 the cases reported were
distributed among the industries as follows:
T a b l e 1 2 . — CASES

OF A N T H R A X R E P O R TE D IN FRA N C E, 1910 TO 1912.

[Compiled from Reichs-Arbeitsblatt, July, 1914, p. 589.]
1910

Industry.

1912

1911

Leather...........................
Wool................................
Hair.................................
Other...............................

36
10
4
4

23
7
3
9

22
6
5
5

Total........................

54

42

38

According to sex the cases were distributed as follow s:
Year.

Males.

1910............
1911............
1912...........

Females.

Total.
54
42
38

15
7
9

39
35
29

HOLLAND.

Until 1905, when it was decided .that workmen suffering from
anthrax should receive indemnity in accordance with the workmen’s
compensation act, there was no obligation upon either employers,
patients, or physicians to report cases of the disease. Nevertheless,
subsequent inquiry in North Brabant, the principal seat of the Dutch
tanning industry, yielded the following data:
T a b l e 1 3 . — CASES

OF H UM AN A N T H R A X R E P O R TE D IN H O L L A N ® , 1898 TO 1911.

[Source: Direccie van den Arbeid.

Year.

1898
..........................
1899
...............................
1900.......................................
1901 .....................................
1902 .....................................
1903.......................................
1904
1905.......................................




De Looinijverheid in Nederland, The Hague, 1913, p. 115.]

Total
Cases
cases among
re­
tanners.
ported.
2
1
2

2
1
2

2

2
2

1

2

2
2

Fatal
cases.

1

Year.

Total
Cases
cases among Fatal
re­
tanners. cases.
ported.

1906.......................................
1907.......................................
1908.......................................
1909.......................................
1910.......................................
1911.......................................

5
9
5
9
5
3

5
9
4
8
5
3

1

Total.........................

47

45

4

1

125

A N T H R A X AS A N O CCU PATIO N AL DISEASE.

The influence of the compensation law in encouraging the report­
ing of cases is clearly seen in the figures for the later years. The
general director of labor estimates that in the tanning industry there
are annually, per 1,000 workmen, 4.7 cases of infection and 0.3 deaths.
In 1911 a new labor code was enacted, section 21 of which requires
the reporting of occupational diseases. The reports are to be sent to
the general director of labor within eight days of the diagnosis. For
each report a fee of 22 cents is paid, and a fine of $20 is provided for
failure to comply with the law. The report is made according to a
prescribed form, giving name, sex, age, and residence of the patient,
also the diagnosis, nature of establishment, kind and duration of
work, and other necessary data. An interesting educational section
of the lav/ requires the doctor to have a manual describing the
causes and symptoms of each disease to which the statute applies, as
well as the occupations in which the disease may occur.
For the year 1912, 16 cases of industrial anthrax were reported,
7 of which occurred among brush workers.1 These figures are prob­
ably incomplete, as is usually the case with data obtained for the first
year of the operation of a law.
ITALY.

Data for Italy, where anthrax is reportable as an infectious dis­
ease, show tremendous prevalence of the disease. Sclavo gathered,
from 1880 to 1890, records of 24,052 cases among human beings, of
which 5,812 were fatal. These figures are carried down to the end
of 1904 in the following table:
T able

1 4 .—RECO RD ED CASES OF HUM AN A N T H R A X IN IT A L Y , 1890 TO 1904.

[Source: C. H. W. Page, British Industrial Anthrax, In Journal of Hygiene, November, 1909, p. 291.]

Year.

1890______________
1 8 9 1 _____________
1892 _____________
1893 _____________
1894 _____________
1895 _____________
189ft
1897______________
1898______________

Cases.

2,047
2,241
2,077
2,461
2,400
2,179
1,985
2,123
2,327

Deaths.

526
645
650
598
635
621
453
460
433

Deaths
per 100
cases.
25.7
28.8
31.3
24.3
26.5
28.5
22.8
2l! 7
18.6

Year.

Deaths.

Deaths
per 100
cases.

1899 _____________
1900______________
1901______________
1902______________
1903______________
1904__ ____ _______

2,672
1,867
1,992
3,528
3,423
3,104

461
330
341
403
397
355

17.3
17.7
17.1
11.4
11.6
11.4

T otal_______

36,426

7,308

20.1

1 W a lter A b e lsd o r ff: G ew erblich e M ilzb ra n d v erg iftu n g en in
E n g la n d , und H ollan d, 1 9 1 5 , p. 9.




Cases.

D eu tsch la n d , F rank reich,

126

B U L L E T IN OF T H E B U REA U OF LABOR STATISTICS.

For later years the data have been published irregularly, but the
following are obtainable: 1
Y ear.

Cases.

1905___________________________________________________________ 2, 893
August-December, 1908_______________________________________ 2,188
190 9
2, 736
191 0
2,252
January-May, 1911____________________________________________
364

Most of these cases, it should be said, arise in the nonmanufac­
turing districts.
R U SSIA.

In Russia epidemics of the malady are common, under the name
“ Siberian pest,” 528 persons having died of it from 1867 to 1870 in
the single Province of Novgorod. Javorsky is authority for the
statement that in the whole country more than 10,000 cases are annu­
ally observed. Even this appalling figure would seem to be too low,
for Popov2 declares that in the years 1904 to 1908, inclusive, there
were 80,498 cases, or more than 16,000 a year. As in Italy, however,
it is believed that the majority of cases occur outside of the manu­
facturing industries.
The data for other European countries are even less reliable. In
Austria the law of April 14, 1913, made human anthrax, among
several other infectious diseases, reportable. Earlier reports of the
factory inspectors give the following data for the years 1903 to
1906: 1903, 15 cases; 1904, 5 cases; 1905, 13 cases; 1906, 4 cases.
These fluctuations, however, seem improbable, and the figures as
a whole appear to be too low, for in the report for 1907 a factory
inspector stated that in the brush factories of his district alone 50
cases of anthrax had occurred in the preceding 10 years.
P R O T E C T IV E L E G IS L A T IO N .

Absolute prohibition of the importation of animal materials from
countries where anthrax is known to exist, unless such materials are
first thoroughly disinfected, would probably put an effective stop to
the ravages of the malady among industrial workers. No country,
however, has yet found such a step either commercially or adminis­
tratively possible. Many of them—France, Germany, Great Britain,
Holland, Hungary, Italy, and Spain, for instance—do prohibit the
employment of women or of children of different ages in dangerous
processes, but the great mass of European legislation on occupational
anthrax is confined to more or less careful general regulation of the
hazardous trades and occupations.
1 C om piled from R iv is ta di Ig ien e e di S a n ita P u blica.
2 H. B. P o p o v : R u ssk i V r a tc h [T h e R u ssia n P h y s ic ia n ], J u n e 1 4 , 1 9 1 4 , p. 8 4 8 .




A N T H R A X AS A N

O CCU PATIO N AL DISEASE.

127

WOOL, HAIR, AND BRISTLES.

Of the industries in which there is danger of anthrax, those which
involve the handling of wool, hair, and bristles have been most
widely and thoroughly brought under Government regulation.
In England the wool industry has reached a high degree of devel­
opment, and much of its raw material comes from Persia, East India,
China, and other countries where anthrax is endemic and precau­
tionary measures are almost unknown. Its attention having been
drawn by the frequency of anthrax among wool sorters, the English
Government called in 1884 a conference of public health officials,
representatives of the workers, and wool merchants. At this con­
ference the first tentative set of regulations for the wool industry was
adopted. In 1897 instructions were published for wool-sorting and
in 1900 for wool-dyeing establishments.
In 1905 the Home Office issued regulations which codified and
amplified the earlier rules. They refer1 to the work of sorting,
“ willeying” (willowing), washing, combing, and carding wool, goat
hair, and camel hair, and the incidental processes. Only certain
specified materials, imported chiefly from Asiatic countries, come
under these regulations. Detailed instructions are given for the
opening and handling of wool or hair. Each bale may be opened
only after it has been thoroughly steeped in water and only by men
skilled in judging the condition of the material; screens, sorting
boards, and willowing machines of specified construction are
required. Several kinds of materials must not be sorted except in a
damp state and after being washed. Goods must be stored only in
places set apart for the purpose. Detailed regulations are set forth
for ventilation, cleanliness, disposal of waste, working clothes, and
requisites for treating scratches and slight wounds. Strict require­
ments apply to the places where unwashed wool or hair of the kinds
named is handled or stored. For persons working in those rooms
there must be sufficient washing accommodations, with soap, nail­
brushes, and towels, and proper places for keeping food and clothing.
A worker having an open cut or sore must not be employed in any
such room.
The regulations prescribed for the employers are followed by
instructions to the workers, who are also made responsible for com­
pliance with the rules. Attached to the regulations is a note describ­
ing the dangers of anthrax and urging personal cleanliness.
These regulations apply only to the more dangerous kinds of
wool, and therefore protect only part of the woodworkers of the
United Kingdom; all other kinds o f wool are disregarded, as, for
instance, those coming from South Africa and South America, which




iSee pp. 1GS-171.

328

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

are not classified as “ dangerous,” but which also cause anthrax,
although less frequently than the materials mentioned by the regula­
tions. The insufficiency of the regulations is, indeed, generally agreed
upon, and revision is now being considered by the departmental
committee on anthrax.
Prevention of anthrax in the trades using the coarser kinds of hair
was not taken up by the British Government until several years
later, probably because the danger was less conspicuous than in the
wool industry. Processes involving the use of horsehair from
China, Siberia, or Russia were made subject to regulation in 1908.1
These countries are specified because hair shipped from there is con­
sidered particularly dangerous. These rules contain for the first
time the significant requirement of disinfection, which may be car­
ried out by steam or by any other method certified by a Governmentrecognized laboratory. Rules are also set forth for the opening,
sorting, and storing of nondisinfected material, exhaust drafts of
a prescribed kind are required, and instructions are given for the
disposal of dust collected during the various processes. The require­
ments with regard to working clothes, respirators, supplies for treat­
ing wounds, cloak and lunch rooms, and lavatories are similar to
those contained in the regulations for work on wool. As in those
regulations, also, the workers are called upon to observe the pre­
scribed rules. An important factor in the success of these measures
is the provision which imposes a penalty not only upon the recal­
citrant employer but also upon the worker who fails to observe the
law. This provision is found in section 85 (2) of the Factory and
Workshop Act of 1901: “ I f any person other than an occupier,
owner, or manager, who is bound to observe any regulations under
this act, acts in contravention of, or fails to comply with the regula­
tions, he shall be liable for each offense to a fine not exceeding £2
T$9.73] ” 2
In Germany industrial anthrax appears to be particularly preva­
lent among hair and brush workers, and detailed legislation for that
industry was secured fairly early. The question is taken up by an
order of the Federal Council of October 22, 1902,3 which superseded
a similar order of January 28, 1899. The German order agrees in
its main points with the British regulations. Both require disinfec­
tion of materials, isolation of nondisinfected goods, special working
clothes, and dressing rooms and lunch rooms for the workers who
come in contact with raw products. Factory sanitation and personal
hygiene are also prescribed along similar lines. But, contrary to
the English law, the German decree applies not only to goods coming
1 Appendix B, p. 172.




2 I Edw. VII, ch. 22.

« See Appendix B, p. 177.

129

A N T H R A X AS A N O C CU PATIO N AL DISEASE.

from certain countries but to all horse, cattle, and goat hair and pigs’
bristles of foreign origin. It also differs from the English law in
several other important points. For instance, public disinfection
stations are established, indicating great interest on the part of the
Government. The employer is required to furnish the workers facili­
ties for warm bathing twice a week and to see that each individual
wears the working clothes assigned to him. Perhaps the most sig­
nificant provision is that allowing the employer to discharge without
notice and without liability for breach of contract any worker who*
after repeated warning, persists in violating the rules. In addition
to its salutary disciplinary effect upon the employee, this provision
is of considerable consequence in a country like Germany where
anthrax is compensated as an industrial injury, as it safeguards the
employer’s financial interests against the employee’s possible care­
lessness.
French regulations for the prevention of anthrax in the industries
under discussion are contained mainly in the decree of October 1,
1913,1 which superseded all earlier laws. This decree, like its prede­
cessors of 1908 and 1910, does not follow the English or German
method of special regulations for each industry or allied group of
industries, but applies to all establishments in which the employees
are menaced by anthrax, including those “ where skins, fur, horsehair,
hogs’ bristles, wool, horns, or bones, or other animal products liable to
be infected ” are handled. Special attention is given to the protection
of workers engaged on nondisinfected material or on the process
of disinfection. The methods of disinfection used must, as in Eng­
land and Germany, be officially approved. The rules referring to
sanitation in the work place, working clothes, dressing rooms, lava­
tories, and personal cleanliness are very similar to those prescribed
by the two countries already discussed, but lack their minuteness and
definiteness. Walls, floors, tables, and benches, for instance, must
be washed, not at definitely stated intervals, but 4 whenever neces­
4
sary,” or 4 as often as may be necessary,” and must be 4 frequently ”
4
4
disinfected. The vital matter of dust prevention, which is taken up
with considerable care in England and Germany, has received little
thought from the French authorities. Instead of requiring dustremoving devices the law simply states that wool, horsehair, other
animal hair, and bristles must be handled, 4 whenever possible,” in
4
closed vessels. I f this is impracticable, as for instance, in the case
of opening bales or beating, the operations must be carried out
4 under such conditions as will allow the collection of all offal and
4
its subsequent destruction.”
See Appendix B, p.

1

141633°— B u ll. 267— 20




9

175

.

130

B U L L E T IN OF T H E BU R E A U OF LABOR STATISTICS.

Another preventive device which escaped the attention of the
French lawmakers is that of imposing some responsibility upon the
workers. Overalls and respirators provided by the firm can not
serve their purpose unless they are worn, and the best equipped
T
lavatories and dressing rooms are useless if the worker ignores them.
Consequently, pressure must be exercised not only on the employer
but on the worker also. French employees, however, are merely
asked, through regulations posted in the workrooms5to use the vari­
ous working articles provided for them, as well as the washstands
and dressing rooms, to clean themselves before leaving the premises,
and to bring no food into the workrooms.
In Hungary workers in brush factories and in all establishments
where horse and cattle hair and pigs’ bristles are manipulated are
protected against anthrax by an order of the minister of commerce,
issued on May 18, 1903. This order is practically the sanre as the
order of the German Federal Council of October 22, 1902.
The majority of cases of anthrax in Belgium have occurred among
brush workers, and this circumstance prompted the royal order of
August 20, 1908. In striking contrast to the previously discussed
legislation, this order consists of only two short sections and merely
prescribes, imperatively, the disinfection of hair in a manner “ suffi­
cient to kill the anthrax spore.” Medical inspectors are to test,
through samples of disinfected hair, the effectiveness of the method
used.
HIDES AND SKINS.

Another large group of industries in which the need of Govern­
ment activity against anthrax has been felt by several European
countries is that connected with hides and skins, especially in the
T
processes of tanning. The problem of infection from imported hides
and skins was taken up in Great Britain in 1899. In 1901 rules were
T
published by the Home Office for establishments using dry and drysalted hides and skins imported from China or from the west coast
of India.1 It was required that provision be made for overalls and
gloves, for the keeping of food and clothing, for washing accom­
modations, and for the dressing of wounds. Notes are added to
the rules, one calling the worker’s attention to the dangers of an­
thrax, and another reminding him of his obligation to observe the
law.
Prussian workers engaged on imported hides and skins are covered
by a ministerial order issued on May 9, 1902. It briefly describes the
nature of anthrax and its danger to the worker and emphasizes the
necessity of precautionary measures.2
1 See Appendix B, p. 167.




2 See Appendix B, p. 180.

A N T H R A X AS A N O C CU PATIO N AL DISEASE.

131

A later and more effective measure was the decree of the Prussian
minister of commerce dated December 20, 1910. This directs factory
managers to adopt for the protection of tanners the regulations issued
by the Leather Trade Association, which were based on the latest
scientific investigations and were framed in conformity with the re­
quirements of the Imperial Health Office.1 The rules apply to raw
sheep and goat skins and to all skins and hides imported in a dry,
raw state. These materials must be kept in isolated storerooms.
Detailed rules are prescribed for the sanitation of the storerooms
and for the transportation and handling of the goods. The familiar
instructions with regard to working clothes, lavatories and lunch­
rooms are also found, as well as an interesting rule forbidding the
worker to enter the lunch room, to eat any food, or to leave the
premises until he has changed his working clothes and has thoroughly
washed the face, head, hair and beard, neck, hands, and arms. Each
new worker receives a copy of regulations for the prevention of
accidents, and instructions concerning anthrax.
Other States of the German Empire have also accepted these regu­
lations. Stuttgart, the capital of the Kingdom of Wurttemberg,
for instance, is an important center of the glove industry. There
were revealed in the first year of the operation of the compulsory
notification law of 1909 22 cases of anthrax^ of which 2 were fatal.
This indicated a greater prevalence of anthrax among tannery
workers than was shown by earlier data, and as a result the regula­
tions for the leather industry were introduced by ministerial order.2
The French regulations for tanneries have been discussed in the
preceding section.
Incidentally it may be remarked that in Italy, the home of the
Sclavo serum and the scene of much intelligent private activity
against anthrax, the Government remains practically inactive on the
question. Despite the appalling prevalence of the disease no legis­
lation exists for its prevention among industrial workers.3 In 1911,
in accordance with a decree of the minister of agriculture, industry,
and commerce and a decision of the administrative council of the
national workmen’s accident insurance fund, prizes were offered for
the best essays on a number of topics connected with industrial
safety and hygiene. One of the subjects was prevention of anthrax
among workers employed in the transportation and treatment of
skins, but none of the essays submitted were deemed worthy of the
T
prize.
1 See A ppend ix, p. 1S1.
2 B u lle tin o f th e I n te r n a tio n a l L abor Office, V ol. V III, 1 9 1 3 , p. X V I.
3 L. D ev o to a nd F. M a s s a r e lli: II C harboncliio P r o fe ssio n a le , II L avoro, J u ly 1 5 , 1 9 1 4 ,
p. 1 9 4 ,




132

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

COMPENSATION FOR ANTHRAX AS AN INDUSTRIAL INJURY.

Thorough as is much of the administration of European factory
law, the “ policing ” method alone has not been depended upon for
the enforcement of regulations for the prevention of anthrax. The
method of cooperative pressure on employers through workmen’s
compensation, which has proved so effective in reducing work acci­
dents, while at the same time it safeguards the economic position
of the injured or of their dependents, has already been applied to a
number of occupational diseases, but to none so early or so widely
as to anthrax. At least five European countries—Great Britain,
Germany, France, Italy, and Holland—as well as South Australia
and five Canadian Provinces, already provide compensation for this
disease.1
The British Workmen’s Compensation Act of 1897, the first of its
kind in any English-speaking country, established indemnity for
personal injury “ by accident” arising out of and in the course of
employment. In 1905 the House of Lords was called upon to deter­
mine, on an appeal, whether the dependents of a workman who had
died of anthrax were entitled to compensation under this act. The
House decided in the affirmative, Lord Macnaghten saying:
It is plain, I think, that the mischief which befell the workman in
the present case was due to accident, or rather, I should say, to a
chapter of accidents. It was an accident that the noxious thing that
settled on the man’s face happened to be present in the materials
which he was engaged in sorting. It was an accident that this
noxious thing escaped the down draft or suck of the fan which
the Board of Trade, as we were told, requires to be in use while work
is going on in such a factory as that where the man was employed.
It was an accident that the thing struck the man on a delicate and
tender spot in the corner of his eye. It must have been through some
accident that the poison found entrance into the man’s system, for
the judge finds that there was no abrasion about the eye, while the
medical evidence seems to be that without some abrasion infection is
hardly possible. The result was anthrax, and the end came very
speedily. Speaking for myself, I can not doubt that the man’s death
was attributable to personal injury by accident arising out of and
in the course of his employment. The accidental character of the in­
jury is not, I think, removed or displaced by the fact that, like many
other accidental injuries, it set up a well-known disease, which was
immediately the cause of death, and would no doubt be certified as
such in the usual death certificate.2
1
In a d d itio n i t sh o u ld be rem em bered th a t in m o st E u rop ean co u n tries, in clu d in g
A u str ia , C zecho s lo v a k ia , G erm any, G reat B rita in , H ollan d, H u n gary, L uxem burg, N or­
w ay, P o la n d , P o r tu g a l, R oum an ia, R u ssia , and Serbia, a n th r a x is covered by com pu lsory
h ea lth -in su ra n ce la w s, w h ile in six c o u n tries, B elg iu m , D enm ark, France, Icelan d , Sw eden,
and S w itzerla n d , a lim ited am o u n t o f p r o te c tio n is g iv en by sy ste m s o f su b sid ized h e a lth
in su ra n ce.
2 B r in to n s (L td .) v. T urvey, 9 2 L. T. R„ 5 7 8 ( 1 9 0 5 ) ,




133

A N T H R A X AS A N O CCU PATIO N AL DISEASE.

Other cases of occupational disease also arose which caused litiga­
tion under the law, so that when Parliament enacted the present
British compensation statute in 1906 it included a list of six trade
diseases (since expanded to 25) which were to be compensated on
the same terms as accidents. One of these six was anthrax.1 Sec­
tion 8 of the law states that if the certifying surgeon for the dis­
trict testifies that a workman is suffering from a disease to which the
act applies and is thereby either unable to earn full wages or is sus­
pended from work, or if death is caused by any such disease and “ the
disease is due to the nature of any employment in which the work­
man was employed at any time within the 12 months previous to the
date of the disablement or suspension, whether under one or more
employers, he or his dependents shall be entitled to compensation
under this act as if the disease or such suspension as aforesaid were a
personal injury by accident arising out of and in the course of that
employment.”
In the seven years 1908 to 1914, the only years for which data are
available, 233 cases of anthrax have been compensated under the
law. The following table shows the distribution of the cases by
year and by industry:
T a b l e 1 5 .—CASES OF A N T H R A X COM PENSATED FOR T H E FIR ST TIME D U R IN G T H E

Y E A R U N D E R T H E B R IT IS H W ORKM EN'S COM PENSATION ACT, 1908 TO 1914.
[Compiled from Home Office annual reports on statistics of compensation and of proceedings under the
Workmen's Compensation Act, 1900, and the Employers' Liability Act, 1880.]

Year.

Cotton.

1908...........
1909___ ...
1910___ . . .
1911...........
1912...........
1913...........
1914...........

1

Total___

1

Wool,
worsted,
and
shoddy.

6
19
20
20
24
16
111

Engi­
neering
Other
textiles. and ship­
building.
4
3
1
1
5

1
1

1

2

Docks.

Total.

1

8
7
5
5
6
18
13

8
5
10
4
6
2
5

23
22
35
30
43
44
36

1

62

40

233

1

1
15

China
Miscella­
and
neous
earthen­ factories.
ware.

Other
metal
work.

It is interesting to note, in connection with the British experience,
that the example of the mother country has encouraged both South
Australia2 and Ontario3 to write into their compensation laws the
principle of indemnity for occupational diseases, each Province
adopting the schedule of six compensable diseases, including anthrax,
with which Great Britain began.
The terms of the German workmen’s compensation code cover only
injuries by 6 accident,” but, as in Great Britain under the law of
6




1 8 E dw . V II, ch. 4 7 , th ird sch ed ule.
2 S o u th A u str a lia , 2 Geo. V, No. 1 0 5 3
8 O ntario, 4 Geo. V, ch. 2 5 ( 1 9 1 4 ) .

(1 9 1 1 ).

134

B U L L E T IN OF T H E B U REA U OF LABOR STATISTICS.

1897, anthrax is held to be an accident and is compensated as such.1
The same situation obtains in Holland by a decision of 1905,2 and in
France.3 In the last-named country the question of indemnity for
trade diseases came up soon after the enactment of the compensation
law in 1898, and a committee on industrial hygiene was appointed
under the Ministry of Commerce to study it. The commission’s
report, published in 1903, concluded with regard to anthrax:
Anthrax has always an external origin and is due to infection by
a microbe; this infection takes place at a given moment, and it cer­
tainly furnishes the element of suddenness required by the law of all
accidents which come under the act of 1898.4
Since the publication of this report the French courts have reversed
their previous opinion^ and in the years 1903 to 1909 they decided
four contested cases which came before them in favor of the injured
workers.
The movement abroad in favor of compensation for occupational
anthrax, as well as for other trade diseases, is not confined to these
seven countries and parts of countries. Section 68 of the Swiss
industrial accident insurance law of 1912 empowers the Federal
Council to 6 prepare a list of substances, the production or employ­
6
ment of which occasions dangerous diseases. Every disease exclu­
sively or essentially due to the action of one of those substances in
an enterprise subject to insurance is deemed an accident within the
meaning of the present law.” It can hardly be doubted that anthrax
would find a place on a list of this kind, but apparently the Federal
Council has not yet exercised its power.
1 P ick en b a ch , B e itr a g zur M ilabrand erkrank ung in der L ed erbranche, A e rtztlic h e r Sachv e rsta n d ig e n Z eitung, 1 9 1 4 , N o. 1 8 , p. 3 6 5 .
2 H. A. V an Y sse lstey n , G eneral D ir ec to r o f L a b o r : A n th ra x , 1 9 1 2 , p. 1.
s J. C a v a ille : Le C harbon P r o fe ssio n n e l, P a r is, 1 9 1 1 , p. 3 4 4 .
4 F ra n ce, C om m ission d ’H y g ie n e In d u str ie lle , M a la d ies p r o fe ssio n n e lle s, P a r is, 1 9 0 3 ,
p. 1 4 0 .




C H A P T E R

V I.

PRESENT STATUS OF THE PROBLEM OF DISINFECTION.

It is obvious that the success of the extensive and energetic cam­
paign against occupational anthrax depends to a considerable degree
on the effectiveness of methods of sterilizing industrial materials.
The significance attached to the question of disinfection has stimu­
lated numerous investigations in the more advanced countries. The
work is chiefly done in private laboratories, but important experi­
ments have also been made under the auspices of the United States
Bureau of Animal Industry and of the Imperial Health Office in
Germany, while facilities for such work are furnished by the Home
Office in England.
The task of finding an adequate and practicable disinfectant is
greatly complicated by several factors. For instance, various kinds
of materials require different modes of treatment. The cost of the
disinfectant and the time of exposure necessary for destroying the
bacilli and spores are also essential considerations, since an expensive
disinfectant, or one acting only slowly, will be rejected by the manu­
facturers. Still more important is the effect of the disinfectant on
the material, since it has been shown that a large number of disin­
fectants otherwise desirable can not be applied without injury to
the goods.
Of the materials liable to convey anthrax to the workers, bristles,
horsehair, goat hair, and a few other kinds of hair have proved most
susceptible to disinfection. A number of methods have been pro­
posed, three of which are considered the most effective and the most
acceptable for industrial purposes. These are: (1) Exposure to steam
for a period varying according to temperature and atmospheric
pressure; (2) boiling in water for two hours; and (3) boiling for at
least 15 minutes in a 2 per cent solution of permanganate of potas­
sium with a subsequent bleaching in 3 to 4 per cent sulphuric acid.
In the disinfection of wool much less has been accomplished. Up
to the present no disinfectant has been found entirely satisfactory
for industrial purposes. In England constant and diligent study of
various germicides is being made by the Bradford Anthrax Investi­
gation Board, which, after nine years of work, reports i1 “ So far
1
p. 6.

A n th ra x I n v e stig a tio n B oard for B rad ford and D is tr ic t, N in th A n n u al R eport, 1 9 1 4 ,




135

136

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

formaldehyde, in the proportion of 1 per cent of neat or proof
strength to 99 per cent of water, with a saturation of the opened
material for seven hours, is the only germicide that has been found
reliable, and even the effect of this germicide must depend upon the
absence of ammonia and of large blood clots. The effect of formalde­
hyde upon the spinning qualities of the material is, however, very
marked, and this germicide can only be recommended for extreme
cases of infected wool or hair.” Further experiments are being
made.
Steam disinfection of wool was also the subject of a series of
experiments by the staff of the board. The results have brought out
the fact that while steam succeeds in destroying the germs its effect is
to discolor light-colored material and to turn yellow white. The wool
becomes brittle, its elasticity and luster are considerably affected,
and the strength of the fiber is also somewhat impaired. As a result
a committee of the board agreed that “ disinfection by steam can not
be applied to ordinary wool or hair except under conditions that
would stop any trade in the sorts so treated.” 1
However, even the officially approved methods of disinfection are
not considered absolutely effective, and occasionally fail to prevent
the occurrence of anthrax. C. H. W. Page, an English authority,
expresses himself with considerable pessimism. “ That steam is
ever likely to be certainly effective in disinfecting horsehair is im­
probable,” he says, “ since the damper the steam the better chance
of destroying the spores, but the greater the damage to the hair;
and the drier the steam the less chance of destroying the spores and
the less damage to the hair. These antagonistic results produce a
deadlock.” 2 He also criticizes the use of steam on bristles because
steam bursts or loosens the bundles, which necessitates an expendi­
ture of time and money for putting them in order again; nor does
he find boiling satisfactory, for in the time necessary to destroy the
spores—two to three hours—the material would be considerably
damaged. His stand on the question of disinfection in general he
summarizes in the words: “ Great care and constant supervision are
necessary to secure satisfactory results, and steam can not be regarded
as absolutely certain in effect, though the great bulk of spores are
destroyed and the vitality of the rest is diminished.”
Very similar is the opinion expressed by another English authority,
Legge, who states that to secure certain destruction of all anthrax
spores absolute reliance can not be placed on either steam disinfection
or simple boiling in the absence of effective supervision; however,
the adoption of one or the other is a material safeguard.3
1 A n th ra x I n v e stig a tio n B oard fo r B rad ford and D istr ic t, E ig h th A n n u al R eport, 1 9 1 3 ,
p. 2 3.
2 J o u rn a l o f H y g ien e, I n d u str ia l A n th ra x , 1 9 0 9 , p. 3 6 9 .
3 F or reco m m en d a tio n s o f a B r itis h d e p a rtm en ta l com m ittee, m ad e a fte r five years*
in te n siv e stu d y o f m eth o d s o f d is in fe c tin g w ool, g o a t hair, and cam el hair, see pp. 1 4 3
to 1 4 5 .




A N T H R A X AS A N O CCU PATIO N AL DISEASE.

137

This unreliability of disinfection has attracted official attention in
the Grand Duchy of Baden, where, notwithstanding the practice of
sterilization, the number of cases of anthrax has increased rather than
diminished. Prompted by this circumstance the minister of the in­
terior, by an order which went into effect October 28,1909, instructed
the proper authorities to make annual examinations of fresh disin­
fected samples of materials used in manufacture.1 The examinations
have shown that disinfection does not kill the spores. Some cases
of failure the author attributes either to the wrong construction of
the apparatus or to the wrong use of it. The individual characteris­
tics of certain kinds of hair also sometimes impede disinfection. In
this connection the author mentions goat hair, which comes in hydraulically pressed bales. Upon unpacking, the whole bale, which
owing to the nature of the hair shows hardly any tendency to fall
apart, is exposed to steam; naturally the steam can not penetrate very
deeply, and after an exposure of one-half hour the temperature 8
inches below the surface is only 114.8° F., which is insufficient for
sterilization.
Still greater obstacles are in the way of disinfection of hides and
skins. Numerous experiments with these materials have so far failed
to discover a reliable and convenient germicide. Sterilization by
steam, frequently applied in the hair industry, is impracticable for
hides and skins, as it injures them for manufacture. Experiments
have been conducted with low-temperature steam disinfection in a
vacuum, which does not affect the skins, but the question of the ap­
plicability of this method for manufacturing purposes has not so far
been settled.
Researches, remarkable for their range and thoroughness, have
been made under the auspices of the Imperial Health Office of Ger­
many. Hailer, one of the investigators, states2 that disinfection of
skins is not an impossibility. Numerous methods have been sug­
gested, but so far they have not been applied outside the laboratory.
The high cost of the disinfectants, their poisonous properties, and
their more or less deleterious effects on the skins, serve as ob­
stacles to their introduction into industry. Of the several layers of
which the animal skin is composed the one used for leather is, ac­
cording to Hailer, sensitive to a temperature of over 104° F., and
also to whole classes of chemical substances, such as the phenols,
aldehyde acids, and heavy metal salts—in fact, to the strongest
germicides. However, some of the substances contained in the skin,
1 L aubenh eim er, U ber die D is in fe c tio n v o n T ierh a a ren zur Z erh iitu n g v o n g ew erb lieh er
M ilzbrand, Z e itsc h r ift fiir H y g ien e und In fectio n s-K ra n k h eiten , 1 9 1 2 , Vol. L X X , pp.
324, 325.
2 E. H a iler, D ie A b to tu n g von M ilzbrandsporen an H a u ten un d F e lle n du rch SalzsaureK o ch sa lzlo su n g en . A rb eiten aus dem K a ise rlic h e n G esu n d h eitsam te. B erlin , 1914,
V ol. X L V II, p. 69.




138

B U LLETIN OF THE BUREAU OF LABOR STATISTICS.

chiefly the albuminoids, make insoluble compounds with these chemi­
cals, and as a result the skins change in appearance and become less
valuable for manufacture. Numerous efforts for the removal of
these difficulties have met with little success.
At present there are two methods of disinfection which give prom­
ise of meeting the necessary requirements; neither has yet been
applied on a large scale, but one, recommended by Seymour-Jones
of England, chairman of the International Commission for the
Preservation, Cure, and Disinfection of Hides and Skins, seems to
be meeting with more approval than the other. This process con­
sists in soaking the dry skins for 24 hours in a 1 to 5,000 solution
o f bichloride of mercury to which is added a 1 per cent solution of
formic acid. After this treatment the skins are transferred for an
hour or so to a saturated solution of common salt in water. The acid
helps to render the bichloride effective because it prevents the forma­
tion o f the insoluble albuminate of mercury, and also because by its
penetrating action the fluid is carried into the center o f the mass of
any organic material that may serve as a protection for the spores.
The process has been the subject o f an exhaustive investigation by
Constant Ponder, who considers it simple, cheap, and effective, and
“ believes that it holds out greater promise of success than any pro­
cess hitherto suggested.” 1 He suggests that the sterilization be car­
ried out in the port of shipment.
The other process was discovered by a German scientist, Schattenfroh. This investigator recommends that hides and skins be
soaked for six hours at a temperature o f 104° F., or for two days at a
temperature o f 68° F., in a 2 per cent solution o f hydrochloric acid to
which a 10 per cent solution of ordinary salt is added. For practical
reasons he considers the former method superior. He maintains that
no injury is done to the skins by this process?
In the United States numerous studies of disinfection against
anthrax have been made by the Federal Bureau of Animal Industry,
as well as by the National Association of Tanners and by the Ameri­
can Leather Chemists’' Association, at whose meetings the problem
is the subject of frequent reports and discussions. In 1910 John H.
Yocum, of the leather chemists’ organization, pointed out that be­
cause o f the action of the mercury salt in forming insoluble com­
pounds with albuminoids and thereby depriving itself of further
power to act on bacteria, immersion in a simple 1 to 1,000 solution
o f bichloride of mercury as then required by the Government could
“ not possibly be effective.” He proposed modifying the process by
1 C o n sta n t P o n d e r : A R ep o rt to th e W o r sh ip fu l C om pany o f L ea th e r S ellers, etc., 1 9 1 1 ,
p. VI.
2 E. H a ile r : D ie A b to tu n g v o n M ilzbrandsporen an H iiu ten und F e lle n du rch SalzsaureK o eh sa lz lo su n g e n . A rb eiten a u s dem K a ise r lic h e n G esu n d h eitsa m te. B er lin , 1 9 1 4 , Vol.
X L V II, p. 6 9 .




A N T H R A X AS A N OCCUPATIONAL DISEASE.

139

adding the bichloride to a saturated solution of common salt, which
would prevent interference with the germicide. This method, how­
ever, he found efficacious only for wet salted hides. For dry hides he
declared it impracticable because of the long time the fluid required
for penetration, and recommended instead the Seymour-Jones proc­
ess, 1 to 5,000 bichloride of mercury with 1 per cent formic acid.
This latter process, Yocum estimated, would entail an expense of
about 7 cents a hide, which he held would be more than equalized
by economies in the selection and tanning of hides which it would
make possible. I f the process were carried on at the point of ship­
ment, it was further pointed out, shippers would not be likely to
dry the hides out again, so that many of the hides now received in
the 6 flint dry ” state would be received as “ wet salts,” with a con­
4
sequent reduction of the danger of anthrax infection through flying
dust. The paper was circulated for discussion at the following
meeting of the tanners,1 who seemed to feel, however, that it should
be subjected to important modification.
Perhaps the most extensive series of American experiments on the
subject are those undertaken by F. W . Tilley, of the United States
Bureau o f Animal Industry.2 These experiments tend to show that
the original Seymour-Jones process, immersion in 1 to 5,000 mercuric
chloride solution with 1 per cent formic acid for 24 hours, is not
efficient in killing anthrax spores, even if the germicide is not later
neutralized as it would be by other substances in the regular course
o f tanning. A modification of the Seymour-J ones method, however,
by using a mercuric chloride solution of twice this strength (1 to
2,500), with 1 per cent of formic acid, is efficient in 24 hours if there
is no neutralization. Hence this latter method, the investigator con­
cluded, seems usable “ provided the treated hides are not to be sub­
jected within a week or two to the action of any substances which
will neutralize the disinfectant. This would be the case, for in­
stance, if the hides were disinfected at foreign ports before ship­
ment to this country.”
Similar researches carried on with the Schattenfroh method, 2 per
cent o f hydrochloric acid in a 10 per cent solution of sodium chloride,
with 48 hours’ exposure, are reported to have “ proved efficient in
every instance.” A European bacteriologist,3 however, is quoted as
having found that this method works well for thin skins, but that
if the skins were “ thick and heavily infected he was able, after
iJ o b n H . Y ocum : D is in fe c tio n o f im p o rted h id es. N a tio n a l A sso c ia tio n o f T anners,
1913.
2 F. W. T ille y : A b a c te r io lo g ic a l s tu d y o f m eth o d s fo r th e d is in fe c tio n o f h id es in fe c te d
w ith a n th r a x spores. J o u rn a l o f A g r icu ltu r a l R esearch , Mar. 1 5 , 1 9 1 5 , pp. 6 5 - 9 2 ;
abridged in J o u rn a l o f th e A m erican L ea th er C h e m ists’ A sso c ia tio n , M arch, 1 9 1 6 .
3 F ra n z S evcik : Zur D e sin fe c tio n v o n M ilzbrandh iiuten. In W ein er A ertalich e M onats c h r ift, V ol. I, No. 3 , pp. 1 2 7 - 1 4 1 .




140

BULLETIN OF THE BUREAU OF LABOR STATISTICS.

very effective neutralization, to extract from pieces of the treated
hides anthrax spores which were virulent.”
In all his work Tilley has emphasized what he considers the ex­
tremely slow and superficial action of bichloride o f mercury. “ Cer­
tainly for a short time,” he says, “ the combination between the bi­
chloride and the spores is what we might call a 6reversible ’ combina­
tion,” and the effect of a neutralizing agent, such as the lime used
in later processes, “ will be to break the combination, and the spores
will, so to speak, come to life again.” 1 For this reason he recom­
mends a long immersion in a relatively weak solution as preferable
to a brief immersion in a stronger solution. On the whole he con­
siders the Schattenfroh method, though not perfect, “ far superior to
other methods and well worth a trial as a standard method for the
disinfection of hides.”
On the other hand, a committee report submitted to the annual
meeting of the American Leather Chemists’ Association in June,
1916, stated that tanners who had tried the Schattenfroh method de­
clared it “ positively injurious ” to hides, while at the same time bi­
chloride of mercury solution o f the strength (1 to 1,000) then re­
quired by the Government was complained of as “ burdensome in
point of cost.” 2 The committee therefore tentatively proposed a new
method to supersede both of these. Stating that no cases of anthrax
had occurred in glue or hair factories using by-products from Ameri­
can tanneries, the committee suggested that bichloride o f mercury
1 to 5,000 or possibly 1 to 10,000, followed by the regular liming
process, “ will prove effective in rendering the anthrax spores in­
nocuous. If, #fter further investigation, this proves to be a fact it
will meet the situation and relieve the tanners from undue burden or
cost.” This suggestion had already been conveyed to the Bureau of
Animal Industry, and as has been seen a slight modification of the
proposed process is embodied in the rules prepared by the Federal
authorities, in cooperation with the tanners’ committee, later in the
year.3
The other products liable to convey anthrax, chiefly bones and
horns, are used to a more limited extent than hair, wool, or hides,
and danger of infection from them is also comparatively slight. For
these reasons their sterilization is less urgent, and it has been almost
disregarded in the spirited campaign for protection against the more
common carriers of the disease.
1 J o u rn a l o f th e A m erican L ea th er C h e m ists’ A sso c ia tio n , J u ly, 1 9 1 6 , p. 3 5 0 .
2 C. R. O b e r fe ll: Cure and D is in fe c tio n o f H id es. C om m ittee rep ort, 1 9 1 6 . J o u r n a l of
th e A m erican L eath er C h em ists’ A sso c ia tio n , J u ly , 1 9 1 6 , pp. 3 3 3 - 3 3 9 .
3 See A p p en d ix A.




C H A P T E R

V II.

RECOMMENDATIONS FOR CONTROL AND PREVENTION
OF AN TH RAX.
The serious difficulties in the way o f a satisfactory solution o f the
occupational anthrax problem have been the subject o f considerable
expert study. Since it has not yet proved possible to eradicate
anthrax even in the countries where the most advanced legislation
on the subject is combined with enlightened private activity, addi­
tional measures o f protection are necessary.
A fter careful study o f the problem several authorities o f world­
wide reputation have set forth recommendations in which they take
up not only the question o f anthrax in manufacturing centers, but
also in the stock-raising countries o f export, and in which the neces­
sity o f international action is emphasized.
O f the recommendations published in recent years four sets are
conspicuous fo r their thoroughness and fo r the extensiveness o f the
ground covered, and are here given practically entire, together with
the United States Surgeon General’s recommendations fo r the steri­
lization o f shaving brushes.
RECOMMENDATIONS OF SUBCOMMITTEE OF INTERNATIONAL
ASSOCIATION FOR LABOR LEGISLATION, 1914.1
A. It is important (in order to be in a position to know the extent o f the
risk o f anthrax infection in industries and the preventive measures necessary
to combat it) that in each country fu ll statistics should be kept o f cases which
arise.
Such statistics should always supply the f o llo w in g in form ation : Age and sex
o f the p a tien t; precise occu p ation ; the kind and source o f the materials
handled at the time o f the attack ; situation and clinical form o f the disease;
result.
It is desirable that these statistics should be as wide as possible and cover
all cases o f anthrax— agricultural as well as industrial.
B. In all premises where the products (w ool, hair, bristles, hides, and skins)
o f animals susceptible o f anthrax are stored and handled in the raw state
the occupier should post up a notice containing—
( a ) An illustration showing the commonest and most characteristic form
o f external anthrax (malignant pustule) ;
(&) A brief account o f its origin and the typical form s o f in fection ;
(c ) A warning to the persons employed as to the im portance o f personal
cleanliness and the necessity o f prompt treatment for every lesion, however
slight.
1 A p p o in ted to co n sid er th e q u estio n o f an th ra x , in accord an ce w ith th e d ecision o f th e
s ev e n th d e le g a te s’ m e e tin g o f th e a sso c ia tio n , 1 9 1 2 .




141

142

BULLETIN OF THE BUREAU OF LABOR STATISTICS.

C.
In all premises where wool, hair, bristles, hides, and skins coming from
suspected countries are stored and handled in the raw state, the occupier should
adopt the follow ing measures. (It will fall to the Government o f each coun­
try to decide on and classify in one or more schedules, according to the degree
o f risk and quantity o f material imported, the countries to be declared “ sus­
pected.” )
1. Inspectors o f factories should be permitted by the occupier to inspect
either the stock book in which is entered the purchase o f material for the
factory or workshop or a snecial register with entries as fo llo w s : Nature and
quantity o f material in trodu ced; date o f r e ce ip t; country o f o r ig in ; state
( whether raw or disin fected) o f the p rod u cts; name pf the vendor. And in the
case o f m aterial said to have been disinfected before introduction into the fa c­
tory, an approved certificate to that effect.
2. A ll scheduled raw m aterials w’hich can be subjected to the operation with-,
out damage should be disinfected.
3. Opening o f bales o f wool, hair, bristles, hides, and skins should always
be intrusted to persons skilled in judging the portions which are damaged.
4. Prelim inary operations regarded as particularly dangerous should always
be carried out in a room, or portion o f a room, set apart for the purpose.
(I t w ill fall to the Government o f each country, having regard to the different
processes o f m anufacture and manipulation custom ary in each country and in
each industry under r e g u la t io n , to define what are the prelim inary operations
to be regarded as dangerous.)
5. W ool and hair sorting should always be carried on so as to perm it o f the
removal o f blood clots adhering to the fleece, and o f bloodstained portions.
These fragments should either be burned or sterilized by a process recognized
as efficient.
6. The prelim inary manipulations as defined above, w hich are carried out on
dusty material treated in a dry state, should be carried on under an efficient
exhaust draft preferably in a downward direction. The dust should never
be allowed to escape into the open air.
The dust collected in a special receptacle should either be burned (unless
coming from material that has previously been w ashed) or rendered harmless
by treatment, chemical or otherwise.
7. The w orkroom s in which the prelim inary processes are carried on should
be kept in a constant state o f clean lin ess; the floors should be impermeable,
and the w ails treated in such a way as to perm it o f thorough washing, or
lime washed at least once a year.
The floor, walls, tables, benches, tools, and machines should be frequently
cleaned.
8. The occupier should provide for the persons employed in the prelim inary
manipulations means for securing personal clean lin ess; a cloakroom ( with
arrangements for keeping separate the ordinary clothes from clothing worn
while at w ork) and a lavatory with an abundant supply o f water (hot and
cold whenever possible), soap, nailbrushes, and towels.
Every person employed in handling raw material should be provided with his
own overalls and head covering.
Persons employed in cleaning dust-extracting machines and receptacles for
dust should be provided w ith respirators.
No food or drink should be deposited or partaken o f in room s where danger­
ous processes are carried on.




AN TH RAX AS AN OCCUPATIONAL DISEASE.

143

9. Medical treatment should be organized on the follow ing lines:
Every person employed having a pustule or pimple resembling anthrax should
report the fact without delay at the manager’s office, whereupon the occupier,
on his part, should cause him to be examined by a surgeon appointed fo r the
purpose.
The name and address o f the surgeon should be entered on the notice provided
under B, above.
10. Every factory and workshop should be provided w ith an ambulance box
kept in good condition and in a place easily accessible.
11. No person under 18 years o f age should be employed in the preliminary
operations defined above.
D.
It is desirable that in all countries where stock is raised, sanitary regula­
tions drawn up on the same lines should be seriously applied with a view to
bring about diminution in the epizootic spread o f anthrax, and destruction by
efficiently organized methods o f all the products or olfal of animals that have
died o f anthrax.
The members o f the subcom m ittee:
De. K o e ls c h , Chief M edical Inspector, Munich.
Dr. Legge, M edical In spector, London.
J. C a v a ille , In spector o f Labor, Castres.

RECOMMENDATIONS BY GREAT BRITAIN: DISINFECTION SUB­
COMMITTEE OF DEPARTMENTAL COMMITTEE APPOINTED TO
INQUIRE AS TO PRECAUTIONS FOR PREVENTING DANGER OF
INFECTION BY ANTHRAX IN THE MANIPULATION OF WOOL,
GOAT HAIR, AND CAMEL HAIR, 1918.
[From report, Vol. I, Cd. 0057, London, 1918, p. 91.]
W e are agreed that a process o f disinfection * * * must consist o f four
stages, as follow s:
Stage 1.— Prelim inary treatm ent, consisting o f agitation (by means o f rakes
w hich thrust the wool through liquid as in scouring m achinery) for 20 minutes
in a solution o f soap in water (preferably also containing an alkali like sodium
or potassium carbonate) at a temperature o f 102° to 110° F., assisted by
squeezing through rollers. The protection afforded to the spores is by this
means removed, the spores are rendered susceptible to the action o f disin­
fectants and the w ool is cleansed.
Stage 2.— Disi7ifecting treatm ent, in which the material is agitated by similar
means for 20 minutes in a 2-2$ per cent solution o f form aldehyde in water at a
temperature o f 102° F., assisted by squeezing through rollers. In this stage
the bulk o f the anthrax spores is destroyed, those only surviving which are
imbedded in remnants o f bloodclots which in a few instances may have escaped
complete disintegration during stage 1, but which become saturated with form al­
dehyde solution.
Stage 3.— D rying in a current o f air heated to 160° F. The moisture in the
w ool is driven off, and nearly all the surviving spores in any blood remnants
are destroyed.
Stage — Standing for some days to ensure by the progressive action o f the
form aldehyde which remains in the blood remnants the complete destruction
o f the few weakened spores which have survived stage 3.
W e are convinced that the key to successful disinfection is the efficiency o f
the prelim inary treatment. Providing this is entirely effective in removing all
protection to the spores, stages 3 and 4 are unnecessary so fa r as disinfection




144

BU LLETIN OF TH E BUREAU OF LABOR STATISTICS.

itself is concerned, though for com m ercial reasons drying is usually a neces­
sity. W e were not able in our experiments to make the first stage so efficient
as to bring about with absolute certainty complete disintegration or solution
o f all protecting substances, except by very prolonged treatment, because we
were compelled by the circumstances under which it was possible to carry out
such an investigation to use inefficient machinery. W e satisfied ourselves,
however, by experiments w ith natural clots, that all blood can be removed
from wool, and that scouring machinery is much more efficient for this purpose
than the apparatus we used. Nevertheless, the possibility is always present
that some small remnants may escape, and w e therefore think stages 3 and 4
should be regarded as integral parts o f the process o f disinfection, which are
in the nature o f safety factors.
[F ro m report, Vol. II, Cd. 9 1 7 1 , L ondon, 1 9 1 8 .]

The policy o f attempting to control the danger o f infection from anthrax in
w ool by regulations under the factory act should be abandoned, and instead
the principle o f compulsory disinfection substituted. * * *
D isinfection o f wool and hair should be permitted only in central disinfection
stations, the sole business o f which is disinfection. * * *
Generally * * * the ports through which w ool is exported to this country
appear to us to offer incontestable advantages as the points at w hich central
disinfection stations should be established.
The infected varieties o f w ool should themselves bear the cost o f disinfection
by means o f a charge levied on the quantity disinfected.
The capital cost o f disinfection should be provided in the first instance by
the British Government, but should be repaid by means o f a sinking fund,
provision fo r w hich should be made by a charge imposed on w ool disinfected.
An organization, which we w ill designate “ the disinfection authority,” should
be constituted by the Government and should be given the necessary powers
and facilities fo r bringing into operation and enforcing disinfection o f w ool and
hair.
The duties o f the disinfection authority should be the organization o f disin­
fection ; the erection, management, and control o f central disinfection station s;
the preparation, publication, and revision o f lists o f materials it is considered
should be subject to the requirement o f disinfection, and o f m aterials not subject
to restriction s; and the exercise o f such powers as may be necessary fo r pre­
venting the admission o f dangerous materials into the country w ithout disinfec­
tion.
The B ritish Government should establish the disinfection authority and should
then take steps to obtain the cooperation o f the Governments o f all organized
countries (1 ) in securing the disinfection o f w ool and hair and (2 ) in such
other measures as the disinfection authority may advise for the general pre­
vention o f anthrax.
Arrangements should be made with the Governments o f British territory
abroad whereby the export o f materials, decided by the disinfection authority
to be dangerous, is prohibited except after disinfection in a disinfecting station
under the control o f the disinfection authority and unless accompanied by a
disinfection certificate. And further, that where possible, similar arrangements
should be made w ith the government o f such other countries as may appear de­
sirable.
All m aterials included in the dangerous lists should be allowed to land only at
fixed ports, unless accompanied by a certificate o f d isin fection ; and the port or
customs officers should be empowered either to refuse admission o f any such ma­




AN TH RAX AS AN OCCUPATIONAL DISEASE.

145

terial, or to permit it to be landed only i f transferred direct from the ship to a
disinfection station.
A small experimental disinfecting station should be established without delay
to settle the type o f station to be used and the arrangements necessary for
bringing the whole scheme into complete operation.
The question o f dust prevention should be allowed to stand over till disinfec­
tion becomes operative, and when the time arrives fo r the abrogation o f the
existing regulations, some inquiry as to the conditions in regard to dust should
be made with a view to the adoption o f such precautions as may then be found
necessary.
The cost o f all general duties o f the disinfection authority should be provided
for by the State out o f State funds.

RECOMMENDATIONS BY C. H. W . PAGE.1
The fact that practically all bristles and horsehair on arrival in this country
are centered for a time in tw o or three London warehouses raises the ques­
tion whether it would not be possible to disinfect the m aterial before distribu­
tion. W ere disinfection thus centralized it w ould be a com paratively simple
matter to protect the limited number o f people exposed to risk in cutting the
knots o f the bundles and spreading the horsehair out for disin fection; then
the necessity for form al regulations in horsehair and brush-making factories
and workshops in a great measure w ould be obviated. The manufacturers
would gain in being freed from risk o f anthrax among their employees and,
further, would be able to use h air that many o f them have preferred to discard
on account o f its dangerous properties.
W ith regard to the measures introduced in Germany a few years ago, and
quite recently in England, m ore stress might be laid on the necessity o f
washing, use o f nailbrush, keeping the nails sh ort; in washing, the use o f an
efficient disinfectant is a d visab le; for this purpose Cyllin does admirably, being
compatible with soap. Experience shows that soap and water are the true
safeguards after handling infected material, and those who use the same stuff
after disinfection should wash hands, face, and neck before going home to a
meal. By these means, too, the likelihood o f w orkers carrying infection outside
would be diminished. The ignorance and carelessness o f the workers are
undoubted factors in the spread o f anthrax. The use o f overalls and gloves,
though unpleasant and disliked by the workpeople, yet is very necessary, as cases
quoted show.
Facilities for bacteriological examination given by the Hom e Office since 1899
fo r verification o f doubtful cases might with advantage be extended to exami­
nation o f suspected samples o f hair, etc.
It would be advisable to require the registrar to communicate with the coroner
in all fatal cases o f anthrax.
W hen possible, walls and pavements o f factories and workshops should be
painted or glazed so as to be easy to clean and disinfect.
Early diagnosis o f anthrax being difficult, it is essential for a medical man
to be attached to each factory, or group o f factories, to whom all cases may be
referred, so that in making a diagnosis the nature o f the employment may be
taken into consideration. By this timely vigilance, remedies, harmless in any
case, may be used with fa r greater prospect o f success.
The duties o f certifying factory surgeons might be extended with advantage
to include the above work, and that there might be no delay they should be
1 F rom sum m ary o f a r tic le on B ritish In d u str ia l A n th rax, Jou rn al o f H ygiene, D ecem ­
ber, 1 9 0 9 , pp. 3 9 0 — 9 5 .
3

141633°— B u ll. 267— 20------ 10




146

BTTLiLETIN OF T H E BXJEEAU OF LABOE STATISTICS.

supplied witli serum by the Hom e Office. The surgeons should collect samples
o f suspected material fo r bacteriological examination, should undertake the
entire treatment o f all cases o f anthrax, and, in conjunction w ith the local fa c­
tory inspector, conduct an inquiry into the source o f infection.
Em ployees absent from w ork should report to the employer the cause, and
in the case o f illness o f any kind the employee should be visited a t once by
the certifying factory surgeon.
The employer should exclude as fa r as possible workpeople with cuts or
abrasions unless suitably covered, and for the carrying out o f all regulations
each factory and workshop should be supplied with, or compelled to supply,
means fo r dressing small cuts, etc.
A ll cases o f human anthrax, whether industrial or agricultural, should be
notified. Both human and animal cases o f anthrax should be notified to one
authority, or to both the board o f agriculture and the Hom e Office, so that if
thought advisable the inquiry may be made in common.
Human anthrax being so closely associated with animal anthrax, more sys­
tematic efforts should be made (1 ) by lim iting the spread o f the disease in
nature, and (2 ) by the immunization o f animals against anthrax to exterminate
the disease among animals.
It is necessary to dispose o f the carcasses w ithout shedding o f blood, so that
no part may be used, either (1 ) by burning, or (2 ) by deep burial, preferably
in quicklime. These methods are equally effective, but perhaps for smaller*
carcasses burning is to be recommended and for larger ones deep burial. All
places likely to have been contaminated with any discharges should be thor­
oughly disinfected, as with 1 in 1,000 corrosive sublimate.
Investigations should be undertaken in each country or by some international
organization, to determine accurately the nature and extent o f anthrax districts,
which should be then kept under supervision and, where possible, drained or
rendered innocuous by other means. Such measures w ould result in a consider­
able reduction in anthrax among anim als and consequently among human be­
ings. Such an organization would give warning o f the prevalence o f anthrax in
these districts, so that export o f infected m aterial might be controlled.
Dust from horsehair factories is not infrequently sold. * * * H ence it
is necessary to prevent the sale o f dust arising in the manipulations o f danger­
ous or nondisinfected raw animal products and to do this separate tables and
rooms should be used fo r such material. Such dust should be burned. The
effluent from wool, hair, and skin factories should be rendered inert by some
reliable process, such as prolonged boiling, before being discharged, or treated
by a suitable strength o f some such disinfectant as Cyllin.
Other general measures, as notification o f all cases o f deaths o f animals
from any acute disease and o f those rendering necessary slaughter on the farm ,
are desirable. A fee should be paid for notification and compensation fo r
animals slaughtered, while failure to com ply w ith these regulations should be
punishable by a heavy penalty.
Animals, except in emergencies, should not be slaughtered or their carcasses
disposed o f except on licensed and inspected premises, and, in all cases o f ani­
mals slaughtered otherwise than by butchers in the ordinary course o f their
business, a veterinary should inspect the carcasses and give a certificate o f the
cause o f death or disease, stating the uses to w hich the carcass may be put,
a copy o f the certificate to be forw arded to the board o f agriculture as well as
to the medical officer o f health.
Inform ation should be furnished to factory and market officials; no butcher
or knacker should purchase the carcass w ithout having seen the certificate.




RECOMMENDATIONS BY PROF. L. DEVOTO AND F. MASSARELLI.1
1. Compulsory antianthrax vaccination o f animals. The committee can not
ignore the fa ct that such a measure is very difficult if not im possible o f execution
in foreign countries where anthrax is endemic, and if lim ited to our own country
it can not have the slightest influence in the prevention o f occupational anthrax.
2. Concentration o f the cargoes o f animal m aterial com ing from foreign
sources in specially designated ports having special .and exclusive storehouses
for said material, fitted up with smooth walls and floors to facilitate periodical
disinfection.
3. Adoption o f sanitary regulations for the transportation o f said material
at the points o f disembarkation— regulations w hich might be form ulated as
fo llo w s :
(a )
Isolate from other merchandise the hides, etc,, o f suspected anim als on
board sailing vessels and steamboats, and after the discharge o f every invoice
disinfect the place o f storage while in transit.
{'b) Use for discharging cargoes o f animal m aterial special lighters which,
until disinfected, are not to serve for other transportation.
( c ) Forbid the transportation o f suspected m aterial on the bare shoulder,
and furnish laborers with impermeable clothing and head covering, this last to
protect securely the throat, back o f the head, and face by means o f a cape;
also supply all facilities fo r washing after work, soap, etc*, i f not disinfecting
solutions.
Analogous regulations should be adopted in railw ay transportation.
4. Request the Governments to make compulsory sanitary regulations (a fter
the manner o f those established in Germany, France, etc.) obligatory on the
part o f m anufacturers and on the part o f workmen in establishments where
animal substances are handled.
5. Preventive vaccination o f the workmen who come into immediate contact
with the imported material.
6. Diffuse among the workmen by means o f pictures, publications, and
models a knowledge o f methods for the early recognition o f the pustules, and
institute a propaganda in favor o f using antianthrax serum as a prophylactic
and curative agent.
1 F rom an a r tic le on II C harbonchio P r o f e s s io n a l, II L avoro, J u ly 1 5 , 1 9 1 4 , p. 1 9 7 .




147

RECOMMENDATIONS BY UNITED STATES PUBLIC HEALTH SERV­
ICE: CIRCULAR LETTER OF WARNING TO STATE AND LOCAL
HEALTH AUTHORITIES AND OTHERS CONCERNED ON ANTHRAX
AND THE STERILIZATION OF SHAVING BRUSHES.
To S tate and local health authorities and others concerned:
The continued occurrence o f cases o f anthrax due to infected shaving brushes
leads this bureau to believe that the suggestion contained in Bureau Circular
Letter No. 136, dated July 31, 1918, recom mending the sterilization o f all
brushes in trade channels, is not being complied, with. Attention is therefore
again called to the fa ct that there are still undoubtedly in trade channels shav­
ing brushes made from m aterial contaminated with anthrax.
Any brushes found in the market w hich do not bear the name or the trade­
mark o f the m anufacturer should be regarded w ith suspicion, and should be
returned to the source from w hich they w ere secured, or should be disinfected.
For the sterilization o f brushes the follow in g procedure is believed to be
effectiv e:
The brush should be soaked fo r fou r hours in a 10 per cent solution o f
formalin (by form alin is meant a 40 per cent solution o f form aldehyde). The
solution should be kept at a temperature o f 110° F. and the brush so agitated
as to bring the solution into contact with all hair or bristles.
I
shall be obliged to you fo r bringing this inform ation to the attention o f all
those interested.
Respectfully,
R upert B l u e ,

Surgeon General.
148




A P P E N D IX A ,— RULES AND REGULATIONS IN THE
UNITED STATES.
UNITED STATES: TREASURY DEPARTMENT AND DEPARTMENT
OF AGRICULTURE JOINT ORDER NO. 2. REGULATIONS GOVERN­
ING THE SANITARY HANDLING AND CONTROL OF HIDES,
FLESHINGS, HIDE CUTTINGS, PARINGS, AND GLUE STOCK,
SHEEPSKINS AND GOATSKINS AND PARTS THEREOF, HAIR,
WOOL, AND OTHER ANIM AL BY-PRODUCTS, HAY, STRAW, FOR­
AGE, OR SIMILAR MATERIAL OFFERED FOR ENTRY INTO THE
UNITED STATES, 1917.
[E ffe c tiv e

Jan uary

1,

1 9 1 8 .]

W a s h in g to n ,

D. C., October 15, 1911.

Under authority o f the act o f Congress approved October 3, 1913, entitled
“ An act to reduce tariff duties and to provide revenue for the Government, and
fo r other pu rposes” (38 Stat., 114), and the act of Congress approved Feb­
ruary 2, 1903, entitled “ An act to enable the Secretary o f Agriculture to more
effectually suppress and prevent the spread o f contagious and infectious dis­
eases o f live stock, and fo r other pu rposes” (32 Stat., 791), the follow ing regu­
lations are issued fo r the purpose o f preventing the introduction o f anthrax,
foot-and-m outh disease, and rinderpest from a foreign country into the United
States.
R e g u la tio n
H ID E S AN D

I.

S K IN S .

S e c t i o n 1. All hides o f neat cattle, calfskins, buffalo hides, sheepskins, goat­
skins, and deerskins offered fo r entry into the United States (except abattoir
and hard, sun-dried hides and skins as hereinafter provided fo r ) may be im­
ported from any country maintaining an efficient veterinary inspection system
when accompanied by a certificate signed by an official veterinary inspector o f
such country, or, in the absence o f such official veterinary inspector, by a
United States consular officer, stating that anthrax is not prevalent and that
neither foot-and-m outh disease nor rinderpest exists in the locality in which
the hides or skins originated. Those articles may also be im ported from any
country which does not maintain an official veterinary-inspection system when
accompanied by a United States consular certificate stating that anthrax is
not prevalent, and that neither foot-and-m outh disease nor rinderpest exists
in the locality in w hich the hides or skins originated. In lieu o f a certificate
showing the nonprevalence o f anthrax and the nonexistence o f foot-and-mouth
disease and rinderpest, a certificate signed by one o f the aforementioned officials
stating that the hides or skins have been disinfected under his supervision by
any o f the methods approved or which may hereafter be approved by the Chief
o f the Bureau o f Anim al Industry, w ill be accepted.
S e c . 2 . A l l hides or skins offered for entry into the United States (except
abattoir and hard, sun-dried hides and skins as hereinafter provided fo r ) which
are not accompanied by any o f the certificates prescribed in section 1 o f this




149

150

B U L L E T IN OF T H E B U REA U OF LABOR STATISTICS.

regulation, or which are accompanied by certificates which do not comply with
the requirements or purposes o f these regulations, may be imported from any
country upon the conditions that they w ill be consigned from port o f entry to an
establishment having proper facilities for their sanitary control and disinfec­
tion ; that they w ill move from port of entry to the establishment in cars or
approved containers, sealed either w ith customs seals or seals o f the Depart­
ment o f A-griculture; that they w ill be handled at port o f entry and. en route
to such establishment in accordance with the provisions o f these regulations,
and that they w ill be disinfected by one o f the methods approved, or which
may hereafter be approved, by the Chief o f the Bureau o f Anim al Industry.
Seals o f the Department o f Agriculture shall be affixed to said cars and con­
tainers only by inspectors o f the Bureau o f Anim al Industry, or b y customs
officers and m ay be broken only by inspectors o f the Bureau o f Anim al In ­
dustry, by customs officers, or by other persons authorized so to do by the
Bureau o f Anim al Industry. Customs seals shall in no case be broken except
by customs officers.
R e g u l a t i o n II.
HARD,

SU N -D RIED

H ID E S A N D

S K IN S ,

A N D A B A T TO IR

H ID E S A N D

S K IN S .

S e c t i o n 1. Hard, sun-dried hides and skins may be im ported w ithout disin­
fection if certified as required in section 1 o f Regulation I to be from a locality
where anthrax is not prevalent, if the bales or hides are distinctly marked
fo r identification, each shipment showing invoice number, names and addresses
o f consignee and consignor, as such hard, sun-dried hides and skins so certified
showing freedom from anthrax can be considered as having been disinfected
by the process o f curing and need not be submitted to any further treatment.
Hard, sun-dried hides or skins may be im ported without being certified to be
from a locality where anthrax is not prevalent, upon the conditions prescribed
in section 2, Regulation I, for the im portation o f uncertified hides and skins.
S e c . 2. Abattoir hides and skins taken from animals slaughtered in Sweden,
Norway, Denmark, Australia, New Zealand, Great Britain, Uruguay, Argentina,
Brazil, and Venezuela when accompanied by a certificate o f an official veterin­
arian o f the country where such animals w ere slaughtered, showing that such
hides or skins were taken from animals free from disease at the time o f
slaughter, may be imported into the United States without disinfection. Abat­
toir hides and skins from the countries specified which are uncertified, and abat­
toir hides and skins from countries other than those specified, may be imx^orted
subject to the requirements o f Regulation I.

R e g u la tio n

III.

g lu e s to ck .

Fleshings, hide cuttings, and parings, or glue stock may be im ported without
disinfection—
(a ) I f accompanied by a certificate signed by one o f the officials mentioned
in section 1 o f R egulation I, showing the nonprevalence o f anthrax in the
locality o f origin ; or
( b ) I f shown upon entry to have been disinfected by h e a t; or
( c ) I f shown to have been disinfected by acidu lation ; o r




A N T H R A X AS A N O C C U P A TIO N A L DISEASE— A P P E N D IX A .

151

<d ) I f shown to have been disinfected by soaking in a milk o f lime or a lime
paste; or
(e ) I f shown to have been dried by exposure to the action o f the sun and -air
for a sufficient time to render each piece o f the hardness o f a sun-dried hide.
I f the said m aterials are not accompanied by the certificate described in
paragraph ( a ) , and are not shown to have been treated by one o f the methods
above indicated, they may be imported, upon the condition that the consignee
or his agent files a satisfactory bond or agreement that said materials and
their containers w ill be handled or disinfected in a manner acceptable to the
Bureau o f Anim al Industry before distribution from the factory or establish­
ment to which consigned.
R e g u la tio n
IV.
BO N ES, H O O FS, A N D H O R N S .

S e c t io n

1. B on es,

h o o fs ,

an d

h o rn s

w h ic h

are

c le a n ,

d ry ,

and

fr e e

fr o m

p ie c e s o f h id e , fle sh , o r sin e w s m a y b e im p o r te d w ith o u t d is in fe c tio n .
S e c . 2 . Bones, hoofs, and horns, with pieces o f hides or tendons' attached,
and also horn piths, may be im ported upon the conditions th a t said m a te r ia ls
be forw arded to a factory ot other establishment in cars or approved containers
sealed in the manner prescribed in section 2, Regulation I, and that the con­
signee or his agent files a satisfactory bond or agreement that such m aterials
and their containers w ill be handled or disinfected in a manner acceptable to
the Chief o f the Bureau o f Anim al Industry.
R

e g u l a t io n

V.

W OO L A N D H A IR .

S e c t io n 1. Raw w ool or hair clipped from healthy live animals, scoured w ool
and hair, and noils o f w ool and hair which have been properly scoured may be
im ported without disinfection or certification.
S e c . 2 . Picked or pulled w o o l or hair, when accompanied by an affidavit o f
the exporter designating the hales or packages thereof b y their markings, indi­
cating the consignor, consignee, and number o f the invoice, and stating that all
the w ool or hair contained in the bales or packages came from animals free
from anthrax, may be im ported upon the conditions that the consignee or owner
o f the w ool or hair, or his agent, files a satisfactory bond or agreement assur­
ing proper facilities o f disinfection at the establishment to which the ship­
ment is consigned and that such w ool or hair w ill be disinfected by proper ex­
posure to a temperature o f not less than 165° F. prior to any transfer or re­
shipment from such establishment. I f such w ool or hair is unaccompanied by
the above-mentioned affidavit it may be im ported upon condition that the
consignee or owner thereof or his agent files a satisfactory bond or agreement
assuring proper facilities for disinfection at the establishment to which the
shipment is consigned and that all o f such w ool or hair w ill be disinfected by
proper exposure to a temperature o f not less than 200° F. fo r at least 15
minutes prior to any transfer or reshipment from such establishment.
S e c . 3. I m p o r t a tio n o f a b a tt o ir p u lle d w o o l w ill b e p e r m itte d w ith o u t r e s tr ic ­
tio n s f r o m

a n y c o u n tr y m a in t a in in g a n e fficien t v e te r in a r y

in sp e c tio n s y s t e m ,

w h e n a c c o m p a n ie d b y a c e r tific a te sig n e d b y a n offic ia l v e te r in a r y in s p e c to r o f su c h
cou n try,

or,

in t h e a b se n c e




of

s u c h officia l v e t e r in a r y in s p e c to r , b y a c e rtific a te

152

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

o f a United States consular officer o f the locality from which shipped to the
effect that said w ool was procured from sheep slaughtered therein and passed
under Government inspection, and that in the process o f wet pulling and dry­
ing it has been subjected to a temperature o f not less than 165° F. Such
certificate shall indicate the number o f bales, marks, names, and addresses o f
consignor and consignee, locality o f origin, date o f shipment, invoice number,
and transporting vessel, and shall also show that the consignment consists
o f abattoir pulled wool, which, in the process' o f wet pulling and drying,, has
been subjected to a temperature o f 165° F.
S ec . 4. W ool or hair not otherwise provided for in these regulations, or not
com plying w ith the provisions thereof, may be im ported upon the conditions
that such articles be shipped from port o f entry to destination in cars or satis­
factory containers, sealed in the manner prescribed in section 2 o f Regulation
I ; that the destination be a factory or establishment having satisfactory fa cili­
ties for disinfecting the same, and that they w ill there be disinfected by proper
exposure to a temperature o f not less than 200° F. fo r at least 15 minutes, or
in such manner as may be directed by the C hief o f the Bureau o f Animal
Industry, prior to any transfer or reshipment therefrom. Such wool or hair
may be stored in bond at the port o f entry, subject to shipment and disinfec­
tion, as herein provided, on being released from bond. The consignee, owner,
or liis agent w ill be required to file a satisfactory bond or agreement to fulfill
all requirements as to shipment and disinfection.
R e g u l a t io n

Y I.

CE RT IF ICA TES FROM O TH ER T H A N O F F IC IA L V E T E R IN A R IA N S A N D C O N SU LA R OFFICERS.
S e c t i o n 1. W henever it shall be, determined by the Secretary o f Agriculture,
after investigation, that in any foreign country or locality thereof in which no
official veterinarian o f the Government or United States consular officer is
located, there is a satisfactory qualified official, authorized by the Government
o f such foreign country to sign and issue certificates stating that anthrax is
not prevalent and that neither foot-and-m outh disease nor rinderpest exists in
the locality from which articles enumerated in these regulations are shipped,
to sign and issue other certificates, to make affidavits and other declarations,
and to supervise the shipment o f hides and skins, glue stock, and other animal
by-products, as specified in the regulations, due notice w ill be given o f such
determination, and thereafter such official may sign and issue the said certifi­
cates, make the said affidavits and declarations, and supervise the shipment
o f hides and skins, glue stock, and other animal by-products, in manner and
form prescribed in the regu lation s; and such acts perform ed by the said official
shall have the same force and effect as if perform ed by an official veterinarian
o f the country o f origin or by an United States consular officer.
S ec . 2. The name o f each foreign official authorized to do and perform the
acts specified in section 1 o f this regulation, when submitted to and approved
by the Secretary o f Agriculture, w ill be published, and the Chief o f the Bureau
o f Anim al Industry shall file with each such official a copy o f these regula­
tions and copies o f amendments which may hereafter be made thereto. No act
specified in section 1, perform ed by a foreign official, shall be recognized unless
perform ed by an official whose name has been published, as required herein,
and whose authority to do such acts has not been revoked.




A N T H R A X AS A N O CC U P A TIO N A L DISEASE— A P P E N D IX A.
R e g u la tio n

153

V II.

H A Y , S T R A W , ETC., A N D M E A T S PA C K E D IN H A Y OR S T R A W .

1. On account o f the existence o f foot-and-m outh disease in the
countries o f continental Europe and South America, and the im practicability
o f disinfecting hay and straw used as the packing on meats offered for entry
w ithout injuring the meats for food purposes, the entry into the United States
from any o f those countries o f any meats packed in hay or straw is prohibited.
Sec. 2. Bran, middlings, and mill feed may be im ported from Argentina w ith­
out being disinfected as prescribed in section 4 o f this regulation i f accom ­
panied by an affidavit o f the shipper, showing that such bran, middlings, or
mill feed was conveyed by chutes directly from the mill in which produced
into the vessels transporting the same to the United States.
S ec. 3. Because o f lack o f danger o f the communication o f disease through
the im portation o f hay, straw, forage, and similar materials, including bran,
middlings, or other mill feed originating in and transported directly from Great
Britain, Ireland, the Channel Islands, Canada, and M exico, such articles may
be im ported into the United States from these countries as long as the above
condition continues to exist w ithout being disinfected as prescribed in section
4 o f this regulation.
S ec. 4. Except as otherwise provided in this regulation, all hay, straw, forage,
or similar materials, including bran, middlings, or other mill feed, offered for
im portation from any foreign country, shall be disinfected in a manner pre­
scribed by the Chief o f the Bureau o f Animal Industry, at the expense o f the
owner, before being unloaded from the vessel or conveyance bringing the
same into any port o f the United States, and when unloaded and landed shall
be stored and held in quarantine for a period o f not less than three months
at some place acceptable to the Chief o f the Bureau o f Anim al Industry, and
under directions prescribed by him.
S e c tio n

R e g u la tio n

V III.

CA N A D A .

Because o f the lack o f danger o f the introduction o f disease into the United
States through the im portation o f the articles enumerated in these regulations
originating in and transported directly from Canada, such articles may be
im ported from Canada as long as the above condition continues to exist without
being disinfected or certified as prescribed by these regulations.
R e g u la tio n
PRODUCTS

FROM

IX .

DISEASED

A N IM A L S .

Im portation into the United States o f any animal by-products, taken or re­
moved from animals affected with anthrax, foot-and-m outh disease, or rinder­
pest, is prohibited.
R e g u la tio n
M ETHODS

FOR

D IS IN F E C T IO N

OF

H ID E S ,

X.
S K IN S ,

AN D

O TH ER

M A T E R IA L S .

Hides, skins, and other materials, required by these regulations to be dis­
infected shall be subjected to disinfection by methods found satisfactory and
approved from time to time by the Chief o f the Bureau o f Animal Industry
o f the United States Department o f Agriculture. The Chief o f the Bureau




154

B U L L E T IN OF T H E BU REAU OF LABOR S T A T IS T I€$ .

o f Anim al Industry is authorized to revoke from time to time any methods
which have been approved by him.
R e g u la tio n
D IS IN F E C T IO N

OF

CARS,

B O AT S,

X I.

OTHER

V E H IC L E S,

AND

PE E M IS E S .

S ection 1. Cars., boats, other vehicles, yards, and prem ises which have been
•used in the transportation, handling, and storing o f uncertified or nondisin­
fected imported hides, skins, and parts thereof, hair, wool, and other animal
by-products, hay, straw, forage, or similar material, permitted entry subject to
disinfection, shall be cleaned and disinfected under the supervision o f the B u­
reau o f Anim al Industry, as indicated in Regulation X I I , and in the manner
provided in sections 2 and 3 o f this regulation. Except as hereinafter provided
in these regulations, cars, boats, and other vehicles which have been used in
the transportation o f uncertified or nondisinfected imported hides, skins, and
parts thereof, hair, wool, and other animal by-products, hay, straw, forage,
or sim ilar material, perm itted entry subject to disinfection, shall not be moved
in interstate or foreign commerce until the said cars, boats, and other vehicles
have been cleaned and disinfected under supervision o f the Bureau o f Animal
Industry in accordance with sections 2 and 4 o f this regulation.
Sec. 2. Paragraph 1, Cars required by these regulations to be cleaned and
disinfected shall be treated in the follow ing m ann er: Collect all litter and
other refuse therefrom and destroy by burning or other approved methods,
clean the exterior and interior o f the cars, and saturate the entire interior sur­
face, including the inner surfaces o f the car doors, w ith a permitted disin­
fectant.
Paragraph 2. Boats required by these regulations to be cleaned and disin­
fected shall be treated in the follow ing m ann er: Collect all litter and other
refuse from the decks, compartments, and all other parts o f the boat used for
the transportation o f materials covered by these regulations, and from the port­
able chutes or other appliances or fixtures used in loading and unloading same,
and destroy the litter and other refuse by burning or by other approved meth­
ods, and saturate the entire surface o f the said decks, compartments, and other
parts o f the boat with a permitted disinfectant.
Paragraph 3. Buildings, sheds, and premises required by these regulations to
b e disinfected shall be treated in the follow ing m ann er: Collect all litter and
other refuse therefrom and destroy the same by burning or other approved
methods and saturate the entire surface o f the fencing, chutes, floors, walls,
and other parts with a permitted disinfectant.
S e c . 3 . Paragraph 1. All hides, skins, and other m aterials subject to disin­
fection at destination under the provisions o f these regulations shall be entered
at ports having docking and unloading facilities separate and apart by not less
than 100 feet, from yards, premises, roads, or runways where cattle and other
ruminants and swine are kept, held, convened, or driven, except for immediate
slaughter. No animals o f the species named, except for immediate slaughter,
shall be permitted on any dock or premises where im ported hides or other
m aterials subject to disinfection at destination are being unloaded, stored,
or handled within 24 hours fallow ing the completion o f such handling, unless
the said hides or other materials have been removed and the place or places
w here they w ere unloaded, stored, or handled, or with which they were in
contact have been cleaned and disinfected in a manner approved by the C h ief
©f the Bureau o f Animal Indnstry.




A N T H R A X AS A N O C CU PATIO N AL DISEASE— A P P E N D IX A.

155

Paragraph 2. Except as otherwise provided in these regulations, all such
hides, skins, and other materials subject to disinfection shall be loaded and
shipped under official supervision and under seals as prescribed in section 2
o f Regulation I.
Paragraph S. Dust and refuse at docks, unloading places, and all warehouses
and other establishments shall be controlled. A ll dust and other refuse shall
be collected and destroyed by burning or other approved methods.
Sec. 4. Paragraph 1. The substances permitted for use in disinfecting cars,
boats, other vehicles, and premises are as fo llo w s :
(а ) Compound solution o f cresol, U. S. P., at a dilution o f at least 4 fluid
ounces to 1 gallon o f water.
( б ) A permitted “ saponified cresol solution ” at a dilution o f at least 4 fluid
ounces to 1 gallon o f water.
( c ) Liquefied phenol (liquefied carbolic acid) at a dilution o f at least 0 fluid
ounces to 1 gallon o f water.
(cl) Chlorid o f lime (U. S. P. strength, 30 per cent available chlorin) at a
dilution o f 1 pound to 3 gallons o f water.
Paragraph 2. The use o f “ saponified cresol solution ” as a substitute for
compound solution o f cresol, U. S. P., as a disinfectant is permitted, provided
that such “ saponified cresol solution ” shall conform to the follow ing require­
ments :
(a ) The form ula o f the product shall employ not less than 28 per cent by
weight o f linseed oil. Either caustic potash, caustic soda, or a m ixture of
caustic potash and caustic soda may be used to saponify the linseed oil. The
cresol used shall be at least 95 per cent pure, and enough o f this commercial
grade o f cresol (cresylic acid) shall be employed in compounding the disin­
fectant to bring the actual amount o f cresol in the finished product up to 50
per cent.
(h )
The product shall remain a homogeneous liquid when cooled to 32° F.
It shall contain substantially no unsaponified linseed oil or excess alkali. It
shall be readily soluble in cold distilled w a te r ; the solution shall be practically
clear and shall contain no globules of*undissolved oil or cresylic acid.
(c ) M anufacturers wishing to offer saponified cresol solution as indicated
above fo r use in official disinfection shall first submit a sample o f at least 8
ounees fo r examination, together with a statement o f the form ula employed
and a guaranty that the product w ill be maintained o f a quality uniform with
the sample submitted.
(d ) To prevent confusion, each product shall bear a distinctive trade name
or brand, together with the name o f the m anufacturer or distributer. There
shall be no mention o f the United States Department o f A griculture or the
Bureau o f Anim al Industry on the labels, containers, or printed matter accom ­
panying products permitted to be used in official disinfection. The permitted
saponified cresol solution shall be used at a dilution o f at least 4 ounces o f the
solution to 1 gallon o f water.
R e g u la tio n

X II.

PLAC A B D IN G CAES AN D M A R K IN G B IL L IN G .
S e c t i o n 1. Transportation companies shall securely affix to and maintain
upon both sides o f all cars carrying uncertified or nondisinfected imported
hides, skins, and parts thereof, hair, wool, and other animal by-products, per­




156

B U L L E T IN OF T H E B U REA U OF LABOR STATISTICS.

mitted entry subject to disinfection, durable placards not less than 5$ by 8
inches in size, on which shall be printed with permanent black ink and in bold­
faced letters not less than 1^ inches in height the words “ U N C E R T IF IE D IM ­
PO RT AN IM A L PRO D U CT.” These placards shall also bear the w ords
4 CLEAN AN D D ISIN F E C T T H IS CA R .” Each o f the waybills, conductors’
4
m anifests, memoranda, and bills o f lading pertaining to such shipments shall
have the w ords “ U N C E R T IF IE D IM PO R T AN IM A L PRODUCT, CLEAN
A N D D IS IN F E C T CA R,” plainly w ritten or stamped upon its face. I f for any
reason the placards required by this regulation have not been affixed to the
car, or the billing has not been marked by the initial or the connecting carrier,
or the placards have been removed, destroyed, or rendered illegible, the placards
shall be im mediately affixed or replaced and the billing marked by the initial
or connecting carrier, the intention being that the billing accom panying the
shipment shall be marked and the car placarded as herein specified from the
time such shipments leave the port o f entry until they are unloaded at final
destination and the cars are cleaned and disinfected as required by Regulation
X I.
Sec. 2. I f it is necessary to unload en route any o f the products specified in
this regulation, the car from w hich the transfer is made and any part o f the
premises at the point o f transfer which may have been contaminated shall be
cleaned and disinfected by the transportation company, in accordance with the
provisions o f Regulation X I, and the transportation com pany shall immediately
report the transaction, by telegraph, to the Chief o f the Bureau o f Anim al In­
dustry, W ashington, D. C. Such report shall include the inform ation indicated
as follow s: {a ) Nature o f em ergency; (&) place where product w as unloaded;
(c ) original points o f shipment and destination; ( d ) number and initials o f
the original c a r ; also number and initials o f the car into w hich the product
is reloaded in case original car is not used.
S ec. 3. Cars required by these regulations to be cleaned and disinfected
shall be treated in the manner specified in Regulation X I, under the supervision
o f the Bureau o f Anim al Industry, by the final carrier at destination as soon
as possible after unloading and before the same are moved from such final
destination for any purpose except as otherwise hereinafter provided.
W hen the products are destined to points at which an inspector o f the Bureau
o f Anim al Industry and proper facilities are m aintained the cars shall be
cleaned and disinfected at such points under supervision o f such inspector.
W hen the products are destined to points at w hich an inspector or other duly
authorized representative o f the Bureau o f Anim al Industry is not maintained,
the transportation company shall seal, bill, and forw ard the infectious cars to
a point to be agreed upon between the transportation company and the Bureau
of Anim al Industry, and at w hich an inspector is maintained. The transporta­
tion company shall there clean and disinfect the said cars under the supervision
o f the Bureau o f Anim al Industry.
W hen the products are destined to points at w hich an inspector o f the Bureau
o f Anim al Industry is maintained, but at w hich proper facilities can not be
provided, the transportation company may, upon permission first secured from
the Bureau o f Anim al Industry, seal, bill, and forw ard the cars to a point at
which an inspector o f the Bureau o f Anim al Industry is maintained and proper
facilities provided, and there clean and disinfect the said cars under the super­
vision o f the Bureau o f Anim al Industry,




A N T H R A X AS A N O CC U P A TIO N A L DISEASE— A P P E N D IX A.
R e g u la tio n

157

X III.

TERRITORIAL POSSESSIONS.

These regulations shall be applicable to all hides, fleshings, hide cuttings,
parings, and glue stock, sheepskins and goatskins and parts thereof, hair, wool,
and other animal by-products, hay, straw, forage, or similar m aterial w hich is
offered for entry into the United States from any place under the jurisdiction
o f the United States to w hich the animal quarantine laws o f this country do
not apply.
P r io r O r d e r A n n u l l e d .

Treasury Department and Department o f Agriculture Joint Order No. 1, o f
October 21, 1916, and all amendments thereto, shall cease to be effective on
and after January 1, 1918, on and after which date this order, which for pur­
poses o f identification is designated as United States Treasury Department and
Department o f Agriculture Joint Order No. 2, shall become and be effective
until otherwise ordered.
L. S. R o w e ,
A cting S ecretary of the Treasury.
D.

F.

H ou ston ,

Secretary o f Agriculture.

UNITED STATES: DEPARTMENT OF AGRICULTURE, BUREAU OF
ANIMAL INDUSTRY. SPECIAL ORDER [B. A. I. ORDER 256] PRE­
SCRIBING METHODS FOR THE DISINFECTION OF HIDES,
SKINS, FLESHINGS, HIDE CUTTINGS, PARINGS, AND GLUE
STOCK, AND OTHER ANIM AL BY-PRODUCTS, HAY, STRAW, FOR­
AGE, OR SIMILAR MATERIAL OFFERED FOR ENTRY INTO THE
UNITED STATES, AND THE CONTAINERS OF GLUE STOCK,
BONES, HOOFS, AND HORNS SO OFFERED FOR ENTRY, 1917.
D i s t r i c t o : f C o l u m b i a , D ecem ber 14, 1917.
In accordance with the provisions o f the United States Treasury Department
and Department o f Agriculture Joint Order No. 2, o f October 15, 1917, “ Regula­
tions governing the sanitary handling and control o f hides, fleshings, hide cut­
tings, parings, and glue stock, sheepskins and goatskins and parts thereof, hair,
wool, and other animal by-products, hay, straw, forage, or similar material
offered for entry into the United States,” the follow ing methods for the disin­
fection o f the above-named m aterials and articles are hereby prescribed,
effective January 1, 1918:

I.

D is in f e c t io n

of

H id e s

and

S k in s

P r io r

to

S h ip m e n t .

H ides and skins disinfected prior to shipment as provided by regulation 1,
section 1, o f said Joint Order No. 2, must be disinfected by one o f the follow ing
m eth od s:
(a ) By immersion for not less than 24 hours in
m ercury solution.
(&) By immersion for not less than 20 hours in a
cent absolute hydrochloric acid (hydrogen chlorid)
chlorid.
(c )
By immersion for not less than 40 hours in
cent absolute hydrochloric acid (hydrogen chlorid)
chlorid.




a 1 to 1,000 bichlorid o f
solution containing 2 per
and 10 per cent sodium
a solution containing 1 per
and 10 per cent sodium

158

B U L L E T IN OF T H E BU E E A U OF LABOE STATISTICS.

( d ) By immersion for not less than 24 hours in a solution containing 1 per
cent form ic acid, and mercuric chlorid in the proportion o f 1 part to 2,500 parts
o f the solution. H ides or skins treated by this process shall be held for tw o
weeks follow in g the treatment before neutralization.
(e ) By dehairing and pickling in a solution o f salt containing a definite
percentage o f mineral acid and packing in barrels or casks while still wet
with such solution, provided the hides or skins are not neutralized within 30
days after being so packed.
II.

D is in fe c t io n

of

H id e s

and

S k in s

A fte r

A r r iv a l

in

th e

U n it e d

S ta te s.

Hides and skins required by regulation 1, section 2, and regulation 2 o f said
Joint Order No. 2 to be disinfected on arrival at a United States port o f entry
shall be moved to an approved warehouse at such port or in sealed cars or
containers to an establishment having proper facilities for their sanitary control
and disinfection. They shall be stored and handled prior to disinfection in
compartments set aside for that purpose, and all hides and skins stored or
handled in such compartments shall be treated in accordance with the follow ­
ing rules:
1. A ll dust, litter, or waste arising from sorting, cutting, handling, or moving
said hides or skins prior to soaking shall be burned or disinfected by exposure
to a temperature o f not less than 100° C. (212° F .) moist heat fo r not less than
15 minutes.
2. The hides and skins shall be subjected to disinfection by one o f the fo l­
low ing m ethods:
(a ) By immersion fo r not less than 20 hours in a solution containing 2 per
cent absolute hydrochloric acid (hydrogen chlorid) and 10 per cent sodium
chlorid.
(7>) By immersion for not less than 40 hours in a solution containing 1 per
cent absolute hydrochloric acid (hydrogen chlorid) and 10 per cent sodium
chlorid.
(c ) By immersion fo r not less than 24 hours in a solution containing 1 per
cent form ic acid, and m ercuric chlorid in the proportion o f 1 part to 2,500 parts
o f the solution. Hides or skins treated by this process shall be held for two
weeks follow ing the treatment before neutralization.
(d ) By immersion fo r not less than 48 hours in a 1 to 1,000 bichlorid o f
m ercury solution.
( e ) By immersion fo r not less than 6 days in a 1 to 5,000 bichlorid o f mercury
solution, plus not less than 5 days in lime o f the usual strength for dehairing.
Or, in lieu o f disinfection by one o f the foregoing mentioned processes, the
effluent shall be subjected to treatment by one o f the follow ing m eth od s:
( / ) H eat the effluent from soak vats, mill drums, breaking machines, or
other sim ilar equipment to a tem perature o f 100° C. (212° F .) and maintain at
that temperature for at least one minute.
(g ) Treat the effluent from soak vats, mill drums, breaking machines, and
other similar equipment w ith chlorin in such manner and in such amount
(n ot less than 250 parts per m illion) as to secure efficient disinfection.
(h ) Subject the effluent from soak vats, mill drums, breaking machines, and
other similar equipment to filtration, the effluent from the filters to be treated
with chlorin in sufficient amount and in such manner as to secure efficient disin­
fection : Provided, h ow ever, That in this method o f treatment the sludge which
collects on the filters shall be subjected to disinfection by heating at a tempera­
ture o f not less than 100® C. (212° F .) for not less than 15 minutes.
(i) Treat the effluent from soak vats, mill drums, breaking machines, and
other sim ilar equipment with 50 parts o f chlorin per million parts o f effluent
and heat at not less than 80° C. (176° F .) fo r not less than 80 minutes.
( j ) In the case o f sheepskins and goatskins, until further notice, by immer­
sion for not less than 12 hours in a solution o f milk o f lim e containing the
equivalent o f 5 per cent o f calcium oxid (C a O ).




A N T H R A X AS A N OCCUPATIONAL. DISEASE— A P P E N D IX A .
I I I . D is in f e c t io n

of

G lue

159

Stock.

All fleshings, hide cuttings, and parings or glue stock shall be moved from the
port o f entry to an establishment having proper facilities fo r the sanitary con­
trol and disinfection o f such materials, in cars or approved containers sealed
with either Department o f Agriculture or customs seals, and, upon arrival at the
establishment, disinfected before removal therefrom by one o f the follow ing
m ethods:
1. By heating in w ater at a temperature o f 100b C. (212° F .) for not less
than 15 minutes, or by heating in water at a tem perature o f not less than 82° C.
(180° F .) for not less than fou r hours.
2. By soaking in milk o f lime or lime paste fo r not less than 24 hours,
3. By soaking in water containing not less than 2 per cent o f absolute hydro­
chloric acid for not less than 20 hours.
4. By soaking in water containing not less 1 per cent o f absolute hydro­
chloric acid fo r not less than 40 hours.
I V . D is in f e c t io n

of

B o n es.

1. A ll horn piths and porous bones classed as glue stock must be moved from
the port o f entry to an establishment having proper facilities for their sanitary
control and disinfection, in cars or approved containers sealed with either D e­
partment o f Agriculture or customs seals, and, upon arrival at the establishment,
disinfected before removal therefrom, as provided fo r glue stock.
2. Bones with pieces o f hide or tendons attached and all other bones not
otherwise provided for shall be moved from the port o f entry to an establish­
ment having proper facilities fo r their sanitary control and disinfection, in
cars or approved containers sealed w ith either Department o f Agriculture or
customs seals, and, upon arrival at the establishment, disinfected before removal
therefrom by one o f the follow ing m ethods:
( « ) By heating in water at a temperature o f 100° Cl (212° F .) for not less
than 15 minutes.
{b ) B y heating in w ater at a temperature o f not less than 82° C. (180° F .) for
not less than fou r hours.
V.

D is in fe c t io n

o f

H o o fs

and

H orn s.

H oofs and horns shall be moved from the port o f entry to an establishment
having proper facilities for the sanitary control and disinfection o f such ma­
terials, in ears or approved containers sealed w ith either Departm ent o f A gri­
culture or customs seals, and disinfected before removal from the establish­
ment by heating in water at a temperature o f not less than 74° C. (165° F .)
for not less than 15 minutes. Bones removed from horns and h oofs that are
required to be disinfected shall be handled as provided for glue stock,
VI.

D is in fe c tio n

o f

C o n ta in e r s

o f

G lu e

S tock ,

B on es,

H o o fs ,

and

H osns.

Containers o f glue stock, bones, hoofs, and horns, w hich under the provisions
o f Regulations I I I and IV o f Joint Order No. 2, are required to be disinfected,
shall be handled as follow s:
{u ) The containers shall be bu rned; or
<b ) The containers shall be subjected to moist heat at a temperature not
less than 100° C. <212° F .) fo r not less thah 15 minutes.
V II.

D is in fe c tio n

of

H ay,

S tra w ,

etc.

Hay, straw, or sim ilar m aterials shall be placed in r compartment made tight
by sealing all crevices therein and then subjected to treatment w ith form alde­
hyde gas applied as follow s:




1G0

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

The form aldehyde gas shall be generated from solutions o f form aldehyde
containing not less than 37 per cent actual form aldehyde by pouring the fo r ­
maldehyde solution onto pulverized potassium permanganate, the form aldehyde
solution and the potassium permanganate being employed in the proportion o f 20
ounces o f form aldehyde solution by weight and 16§ ounces o f potassium perman­
ganate by weight to each 1,000 cubic feet o f space in the compartment to be disin­
fected. Bales o f hay, straw, or other m aterial shall be piled in block so that not
more than 6 inches of any surface o f the bale is in contact with another bale, or if
deemed necessary by the inspector, the bales shall be broken and the straw or
hay loosened, so that a satisfactory penetration o f the form aldehyde gas may
be obtained. The disinfection w ith form aldehyde gas shall be carried out in
compartments in which the tem perature is not less than 65° F.
J. R. M o h l e r ,

Chief o f Bureau o f Animal Industry.

UNITED STATES: PUBLIC HEALTH SERVICE. AMENDMENT NO.
6 TO INTERSTATE QUARANTINE REGULATIONS, 1916, PRO­
HIBITING THE INTERSTATE TRANSPORTATION OF SHAVING
BRUSHES OR LATHER BRUSHES MANUFACTURED UNDER IN­
SANITARY CONDITIONS, 1918.
W a s h in g t o n , July 30, 1918.
To medical officers o f the United States Public H ealth Service, State and local
health authorities, and others concerned:
In accordance w ith the act o f Congress approved February 15, 1893, the fo l­
low ing amendment and additions are hereby made to the Interstate Quarantine
Regulations prom ulgated by this department" January 15, 1916.
Section 1 is hereby amended to read as fo llo w s :
S e c t io n . 1. F or the purposes o f interstate quarantine the follow ing diseases
shall be regarded as contagious and infectious diseases within the meaning o f
section 3 o f the act approved February 15, 1893: Plague, cholera, typhoid fever,
pulm onary tuberculosis, yellow fever, sm allpox, leprosy, typhus fever, scarlet
fever, diphtheria, measles, w hooping cough, poliom yelitis (in fan tile pa ra lysis),
R ocky Mountain spotted or tick fever, anthrax, and epidemic eerebro-spinal
m en in gitis; and any person affected w ith any disease aforesaid, and anything,
living or dead, w hich has been affected w ith or exposed to the contagion or in­
fection o f any such disease, except as otherwise provided in these regulations,
shall be regarded as contagious or infectious until the contrary has been proven.

The follow in g regulations are hereby added to the Interstate Quarantine
R egu lation s:
S ec . 39. No person, firm, or corporation shall offer for shipment in inter­
state traffic, and no common carrier shall accept for shipment or transport in
interstate traffic any shaving brush or lather brush unless m anufactured in ac­
cordance w ith these regulations.
S ec . 40. S having brushes or lath er brushes shall be m ade

only

from

hair

or bristles know n to be free from an th ra x spores.
S ec . 41. U n less h air or bristles are known to be free from a n th ra x spores
before such bristles are m ade up into shaving or lather brushes, their disin­
fection shall be accom plished by one of the follow ing m e th o d s: ( a ) by boiling
the h air or bristles fo r not less than three h o u rs; (b ) by exposing the hair or
bristles to steam under not less than 15 pounds gauge pressure fo r not less
than 30 m inutes w ith a p relim inary vacuum o f not less than 10 inches before
turning on the s te a m ; ( c ) by exposure to stream ing steam for not less than
six hours.
^
S ec . 42. A ll shaving or lather brushes shall be permanently marked

with the name o f the m anufacturer or w ith a registered trade-mark in order to
insure identification o f the m anufacturer and enforcement o f these regulations.




A N T H R A X AS A N O CCU PATION AL DISEASE---- APP E N D IX A.

161

MASSACHUSETTS: RULES AND REGULATIONS SUGGESTED FOR
THE PREVENTION OF ANTHRAX, 1916.1
PR EAM BLE.

Anthrax may be transmitted to man by infected hides, skins, wool, horse
hair, cow hair, goat hair, pigs’ bristles or pigs’ wool, as well as by dried blood,
bones, and other animal products. The bacillus o f anthrax soon dies out
when dried at the ordinary temperature,, but the spores o f the disease may
remain active, under favorable circumstances, for many years. These spores,
inclosed in blood clots, dried and caked on the hair, skin, or wool, are the
usual sources o f infection, owing to the clots breaking up into dust. The dust
arising in the handling, sorting, and manipulation o f the animal products
readily finds its way into the lungs in breathing, or is swallowed in the act
o f eating or drinking. More often, however, the dust finds its w ay into broken
skin by cuts, bruises, or scratched pimples. The result o f this infection is
anthrax. Anthrax, therefore, is chiefly a dust disease.
(I t can be caused
by eating diseased meat and by the bite o f an insect w hich has fed upon
infected carcasses or other m aterial.) W hile the, danger o f anthrax is greatest,
according to all statistics, in the manipulation o f animal products imported
from China, Russia, and Siberia, nevertheless the disease is so widely dis­
tributed that in no country is it unknown. Consequently, the precautions
w hich are most necessary where hides, skins, hair, and w ool from the coun­
tries named are handled can, w ith advantage, be applied to products from
other countries. In the United States there is no interstate, quarantine law
nor disinfection regulation against anthrax.
Protection against anthrax can be grouped under these headings, v iz .:
1. D isinfection o f the material.
2. The avoidance o f dust.
3. The instruction o f the workers.
The experience o f countries where anthrax has been more prevalent than
it has been in this country shows (1 ) that w ool or hair can be readily disin­
fected by steam w ithout injury to the material, and (2 ) that hides and skins
can be disinfected without damage to these articles and without injury to
subsequent m anufacturing processes.
The follow ing rules and regulations shall apply to all establishments where
hides, skins, fur, horse hair, bristles, wool, horns, bones, or other animal prod­
ucts liable to be infected with anthrax are handled.
For the enforcement o f these rules and regulations all products or parts
o f animals shall be considered in a raw state unless they have undergone a
treatment as fo llo w s :
Hides and skins— tanning.
W ool— scouring.
H orse hair, fur, and hog bristles— bleaching.
Horns and bone— boiling for two hours, or treatment with a strong antiseptic.
The follow ing industries shall be considered dangerous w ithin these rules
and regulations, and they shall apply in a special manner in those departments
where these processes are carried on, v iz .:
1. The unpacking, unloading, or other handling, when dry, or before disin­
fection o f the material.
2. The preparation o f horse hair.
3. Tawing, tanning, and fu r dressing.
4. The pulling, scouring, and sorting o f wool.
1 M assachusetts B oard o f Labor and Industries, Industrial Bulletin No. 6.

141633°—B u ll. 267—20----- 11




162

B U L L E T IN OF T H E BU EEAU OF LABOR S T A T IS T IC S
DISINFECTION.

A ll foreign1 hides, skins, horse hair, cow hair or goat hair, pigs’ bristle, and
pigs’ wool, before they are manipulated in any factory or establishment in
this State, shall be disinfected (unless exempted as hereinafter provided) at
the choice o f the manufacturer in one o f the follow ing prescribed w a y s:
A . Hides and Skins.

(1 )
By the Seymour-Jones method, v iz : To 1 pound o f perchloride o f mer­
cu ry add 500 gallons o f water, and to this m ixture add 5 gallons o f form ic
acid {com m ercial 50 per cent strength). In this bath steep the m aterial for
24 h ou rs; or,
<.2) By the Sehattenf roh method, v iz : In a 2 per cent hydrochloric acid solu­
tion to which 10 per cent o f common salt has been added, steep the material
for a few days. A quicker method can be used by substituting a 1 per cent solu­
tion o f hydrochloric acid and 8 per cent o f salt, provided the temperature o f the
solution is maintained at 40° C. (104° F .) for a period o f six hours.
B. Hair, Bristles, and Pigs’ Wool.

(1 ) By letting a current o f steam act on the m aterial for not less than oneh alf hour at a pressure o f 17 pounds (0.15 above atmospheric pressure) ; or,
(2 ) By boiling for at least one-quarter o f an hour in a solution containing
2 per cent o f permanganite o f potassium, and subsequent bleaching with a 3 or
4 per cent solution o f sulphurous a c id ; or,
(3 ) By boiling in w ater for not less than two hours.
E xem ptions.

The disinfection by the manufacturer may be dispensed w ith if he presents
proof in w riting stating that the m aterial has been disinfected in accordance
with the requirements o f the United States Treasury Departm ent or o f the
Massachusetts State Departm ent o f Health.
The m anufacturer shall not be required to disinfect w hite bristles which he
subjects to a subsequent bleaching process before further manipulation, or
which he has bought already bleached (so-called French bristles) and which
have been kept apart from nondisinfected material.
Exemption from the requirements o f section B may be authorized by the
State Board o f Labor and Industries for those materials that, according to
present experience, would be seriously damaged, or for those m aterials that
can be certified to as having already undergone an equally effective disinfection
in the country or State from w hich they have been exported.
Prior to disinfection prescribed by these rules and regulations only such steps
as are indispensable to the exam ination o f the quality o f the material, to the
prevention o f their being spoiled, and to the preparation and the execution o f
the disinfection are permitted in relation to m aterial req^iired fo be disin­
fected, e. g., unpacking and preparing for disinfection.
The stock o f nondisinfected m aterials which are required to be disinfected,
o r which are exem pted from disinfection, shall be stored in separate rooms and
kept apart from the stock that has been disinfected. Access to this room should
be restricted as much as possible so as to avoid unnecessary exposure o f
workmen.
Records.

The employer shall keep a record o f the skins, hides, hair, bristles, wool, aiwl
other material mentioned in these rules and regulations, in such a manner that
the quantity, the source o f supply, ami, so fa r as is knowii, the origin o f the
merchandise received, as w ell as the tim e aaad the m ethod o f disinfection, or the
1 A lso dom estic whenever anthrax is prevalent in the locality from which -Hie m aterial
has been exported.




A N T H R A X AS A N O CCU PATIO N AL DISEASE---- APP E N D IX A.

163

reason for its omission, are clearly set forth. Such records shall be accessible
to the State Board o f Labor and Industries or its representatives.
SA N ITA T IO N OF W ORKSHOPS.

Floors.— In those parts o f the establishment where material capable o f trans­
mitting anthrax is stored or manufactured the floors shall have a w aterproof
covering or other suitable m aterial that permits the ready washing o f such
floors. The floors o f these departments should be washed daily if the w orkroom
is dusty or if cases o f anthrax have occurred recently at the establishment.
W alls and ceiling.— The walls and ceiling o f such workshop or room, -unless
covered with a smooth washable coating or oil painting, should be washed fre­
quently with a disinfectant solution. I f whitewash is used this coating should
be renewed on the outbreak o f cases o f anthrax among workmen employed in
that establishment.
Tables, w orkbenches and seats.— These articles should be washed tw ice a
week with a disinfectant solution, especially if cases o f anthrax have occurred
recently in the establishment.
V entilation.— The w orkroom shall be well aired twice daily by means o f
open windows, for at least h alf an hour, viz, during noonday meal hour and
after the day’s w ork has been finished, or before it has begun again. No w ork­
man should be permitted to remain in the room during this period.
D ust rem oval.— In all workrooms in which dust is a factor there shall be
an adequate exhaust system installed capable o f removing the dust at its origin
and conveying it to a suitable receptacle for subsequent destruction.
It is recommended that hides and skins be submitted to the ordinary “ wet
salting” process immediately after fla yin g ; or if cured by drying, that the hides
and skins be converted back to the “ wet salted ” state by the form ic-m ercury
processes as soon as possible.
In horsehair factories and horsehair dressing, the sorting and hackling shall
not be done except in special w orkroom s separate from the other workroom.
The dust created shall be collected and destroyed.
Carding and dust-extracting machinery as well as mixing, willowing, and
hackling machines, shall be closed over and provided with an adequate and
effective dust exhaust system. The dust shall be collected in a dust chamber
and burned.
The treatment o f wool, horsehair, hog bristles, and fu rs shall take place
whenever possible in closed vessels. In those operations, such as opening of
bales or beating, which can not take place in closed vessels, the process shall
be carried on in such a way as to allow the collecting o f the refuse and its sub­
sequent destruction.
PE R SO N A L PR EC A U TIO N S.

Printed notices issued by th e. State Board o f Labor and Industries shall be
kept posted in a conspicuous place in each department, setting forth the dangers
o f anthrax infection, the early signs and symptoms o f the disease, and the
precautions that shall be taken in order to avoid this infection.
Any employee who is suffering from a cut, scratch, pimple, or crack o f the
skin that has not healfed readily shall report the same to the person in charge
or to factory physician.
Em ployers shall furnish to em ployees impermeable aprons and leggings (o r
rubber boots) in all operations where the body is liable to come in contact with
the w ater used in tanning, scouring, boiling, o r bleaching o f animal product.
Employees shall wear a suitable respirator (loose gauze cloth tied over nose
and mouth may be used) while engaged in the dusty processes o f handling,
sorting, or o f manufacture.




164

B U L L E T IN OF T H E B U REA U OF LABOR STATISTICS.

Em ployers shall provide for the use o f employees overalls and gloves when
handling raw material, and neck protectors when carrying raw material on the
shoulder. R aw m aterial shall be transported on carts or handbarrows when­
ever practicable.
Employers shall see that the materials provided for the use o f employees are
worn by the persons for whom they are intended, and that when these articles
are not in use they are kept in a special place, and that they are disinfected at
least once a wT
eek.
Dressing rooms, wash rooms, and a suitable dining room shall be provided and
fitted up outside the place where dangerous operations are carried on.
There shall be provided an adequate supply o f running hot and cold water,
toilets, washing and drinking facilities, all in accordance with the rules o f the
State Board o f Labor and Industries on toilets. Lockers shall be provided so
that street clothes and work clothes may be kept separate and apart.
Employees shall not bring food into the workroom. The eating o f food in
w orkroom shall be strictly prohibited.
Employees shall be required to take off their w ork clothes before entering the
dining room, and to wash hands, arms, neck, and face before taking their meals
or leaving the premises.
Em ployers shall keep posted in a conspicuous place in each department a
notice legible to all employees stating—
1. The text o f these rules and regulations.
2. W orkshop regulations imposing on employees the follow ing obligations:
(a)
To make use o f the various w orking clothes and other articles provided
for them by the employer.
(&) To make use o f the dressing room and washing facilities.
( c ) To take the necessary measures for cleanliness before eating and before
leaving the workshop.
(d ) To bring no food into the workroom.
3. The dangers o f anthrax infection, and the precautions that should be taken
to avoid them, and the necessity o f employees reporting at once all skin
affections.
4. Name and address o f physician in charge o f the medical service o f the
establishment.
N ote.

The first symptom of anthrax is usually a small inflamed swelling like a pim­
ple or boil. This is often painless. In a few days the pimple becomes black at
the center and is surrounded by other “ pimples.” The poison is now liable to
be absorbed into the system and w ill cause risk o f life if not removed by prompt
and effective treatment. Early treatment is usually su ccessfu l; delay or neglect
usually leads to blood poisoning, often to death.

NEW YORK: STATE INDUSTRIAL COMMISSION, DIVISION OF
INDUSTRIAL HYGIENE, RECOMMENDATIONS, 1916.
I. Every physician should report at once to the State industrial commission
every case o f anthrax coming under his care.
II. In every establishment where articles liable to be infected w ith anthrax
are handled a competent physician should be employed.
III. In every such establishment the employer should make such special
provision for the protection o f his employees as the commission shall deter­
mine.
IV. E very employee should be required to make use o f the means provided
fo r his safety by the employer.




A N T H R A X AS AN O CCU PATION AL DISEASE---- A PP E N D IX A.

165

V. It should be the duty o f the shop forem an or superintendent to enforce
the use by the employees of the means provided by the employer.
VI. Attention o f physicians and o f the public should be called to the dangers
o f anthrax.
VII. Cooperation w ith Federal and contiguous State authorities should be
maintained to prevent the entrance of infected materials into commerce.
TH E

P H Y S IC IA N .

1. He should visit the establishment every day and sign a register showing
the time o f his visit, this register to be subject to inspection by the State indus­
trial commission.
2. He should examine every workman at entrance upon employment, and as
often thereafter as necessary. He should instruct new employees individually,
and the others frequently in classes, in methods o f preventing anthrax.
3. He should be provided w ith facilities fo r the prompt diagnosis and early
treatment of anthrax. Tie should have charge o f the first-aid kits, as approved
by the commission. He should instruct foremen and others selected in the
use o f first aid.
4. He should keep a record of all examinations and o f all treatments, such
record to be subject to inspection by the commission.
H e should report
promptly to the commission every case o f anthrax, together with a record o f
the source o f the infecting material.
TH E EMPLOYER.

1. In factories the floors should be of cement or w aterproofed easily washed
material. The walls should be whitewashed. W hen a case o f anthrax de­
velops the floors should be thoroughly cleaned and the walls whitewashed.
Tables, w ork benches, and other articles coming in contact with materials
should be washed as often as necessary wT
ith a disinfecting solution.
2. Dressing rooms, wash rooms, and lunch rooms should be provided, sepa­
rate from the w ork rooms. The dressing room should be so arranged that the
w orking clothes may be kept separate from the street clothes. The wash
rooms should be provided with basins, water, soap, individual towels, etc., as
directed by the industrial code. No food should be allowed in the workrooms.
3. W here dust is evolved in the process special ventilating apparatus should
be installed according to the judgm ent o f the commission.
4. To avoid, as much as possible, contact with materials, suitable clothing,
w aterproof aprons, overalls, shoes, gloves, etc., should be provided the w ork­
men.
5. Notices in different languages should be posted conspicuously throughout
the w ork room s:
(a ) Requiring the use o f protective clothing; requiring the use o f dressing
rooms and wash ro o m s; forbidding food in workrooms.
( b ) W arning o f dangers o f an th rax; instructing as to methods o f avoiding
i t ; requiring the report to foremen o f even slight accidents or injuries.
6. The forem an or superintendent should be held responsible for observance
o f the regulations.
TH E

EMPLOYEE.

1. He should realize the danger o f anthrax and the necessity o f avoiding
infection.
2. He should wear the clothing and use the dressing rooms, wash rooms, and
lunch rooms provided by the employer. No food should be taken into the w ork­
rooms.
3. He should report at once to the foreman even slight injuries and should
follow strictly directions o f the physician.
4. He should assist the forem an in enforcing the regulations.




166

B U L L E T IN OF T H E BU EEA U OF LABOR STATISTICS.

NEW YORK CITY: DEPARTMENT OF HEALTH. REGULATIONS
GOVERNING THE BUSINESS OF PREPARING SKINS OF ANIMALS,
1915.
Regulations o f the Department o f Health o f the City o f New York, adopted
March 30, 1915, effective A pril 1, 1915, relating to section 328 o f the Sanitary
Code, which provides as fo llo w s :
Sec. 328. Tanning, skinning, and scouring or dressing hides and leather regu­
lated.— No establishment or place o f business for tanning, skinning, or scouring,
or for dressing hides or leather shall be opened, started, established, or main­
tained in the city o f New York, without a permit therefor issued by the board o f
health or otherwise than in accordance w ith the terms o f said perm it and with
the regulations o f said board.
Regulation 1— F loors.— The floors o f scouring, steaming, flushing, tanning,
and dehairing rooms shall be water-tight and graded to properly trapped sewer
connected drains.
Regulation 2— W alls.— The w alls o f scouring, steaming, flushing, tanning,
and dehairing room s shall be painted and made im pervious to dampness.
Regulation 3— Ventilation.— The premises shall be properly and adequately
ventilated by natural or mechanical means or both.
Regulation 4— Disposal o f odors.— Suitable and adequate means sh%ll be pro­
vided fo r the disposal o f all odors and no offensive odors shall be caused, su f­
fered, or allow ed to escape into the outside air.
Regulation 5— Care o f refu se.— A ll refuse shall be kept in tightly covered
metal receptacles and removed from the premises daily.
Regulation 6— M aintenance.— The premises shall be kept m a clean and
sanitary condition at all times.




A P P E N D IX B.— T E X T OF EUROPEAN REGULATIONS.1
GREAT BRITAIN: REGULATIONS FOR HANDLING DRY AND DRYSALTED HIDES AND SKINS IMPORTED FROM CHINA OR FROM
THE WEST COAST OF INDIA, 1901.
D U TIE S OF OCCUPIER.

1. Proper provisions to the reasonable satisfaction o f the inspector in charge
o f the district shall be made for the keeping o f the w orkm en’s food and clothing
outside any room or shed in which any o f the above-described hides or skins
are unpacked, sorted, packed, or stored.
2. Proper and sufficient appliances for washing, com prising soap, basins, with
w ater laid on, nailbrushes and towels, shall be provided and maintained fo r
the use o f the workmen, to the reasonable satisfaction o f the inspector in charge
o f the district.
3. Sticking plaster and other requisites for treating scratches and slight
wounds shall be kept at hand, available fo r the use o f the persons employed.
4. A copy o f the appended notes shall be kept affixed with the rules.
D U TIE S O F P E R SO N S EM PLOYED.

5. No workman shall keep any food, or any articles o f clothing other than
those he is wearing, in any room or shed in which any o f the above-described
hides or skins are handled. He shall not take any food in any such room or
shed.
6. Every workm an having any open cut or scratch or raw surface, however
trifling, upon his face, head, neck, arm, or hand shall immediately report the
fa ct to the forem an, and shall not w ork on the premises until the wound is
healed or is completely covered by a proper dressing after being thoroughly
washed.
N o t e 1. [States that these rules must be kept posted in conspicuous places in
the factory, workshop, or other premises to which they apply, where they may
be conveniently read by the persons employed. Any person who is bound to
observe them and fails to do so, or acts in contravention o f them, is liable to
a p en a lty ; and in such cases the occupier is also liable to a penalty unless he
proves that he has taken all reasonable means, by publishing and, to the best
o f his power, enforcing them, to prevent the contravention or noncompliance.
A printed copy m ust be supplied by the occupier to any person affected by
them if such person applies fo r it. Pulling down, injuring, or defacing any
copy so posted is punished by a fine not exceeding £5 ($24.33).]
N ote 2. [Is an earlier and less complete form o f the note shown on page 140,]
N ote 3 .— Suitable overalls, protecting the neck and arm s, as well as ord inary
clothing, add m aterially to the safe ty o f the w orkm en, and should be provided
and worn, w here practicable, i f dangerous hides are handled.
discarded on cessation o f w ork.

T hey should fee

S im ilarly, for the protection o f the hands,

gloves should be provided and worn w here the character o f the w ork perm its.
1 F rom m onthly bulletin o f the International L abor Office.




167

168

BULLETIN OF TH E BUREAU OF LABOR STATISTICS.

GREAT BRITAIN: SORTING, WILLEYING [WILLOWINGJ, WASHING,
COMBING, AND CARDING WOOL, GOAT HAIR, AND CAMEL HAIR,
AND PROCESSES INCIDENTAL THERETO, 1905.
DEFINITION.

For the purpose of regulations 2, 3 and 18, opening of wool or hair means
the opening of the fleece, including the untying or cutting of the knots, or, if
the material is not in the fleece, the opening out for looking over or classing
purposes.
DUTIES OF OCCUPIERS.

1. No bale of wool or hair of the kinds named in the schedules shall be opened
for the purpose of being sorted or manufactured, except by men skilled in
judging the condition of the material.
No bale of wool or hair of the kinds named in schedule A shall be opened
except after thorough steeping in water.
2. No wool or hair of the kinds named in schedule B shall be opened except
(a) after steeping in water, or (b) over an efficient opening screen, with
mechanical exhaust draft, in a room set apart for the purpose, in which no
other work than opening is carried on.
For the purpose of this regulation, no opening screen shall be deemed to be
efficient unless it complies with the following conditions:
{a) The area of the screen shall, in the case of existing screens, be not less
than 11 square feet, and in the case of screens hereafter erected be not less
than 12 square feet, nor shall its length or breadth be less than 3 i feet.
(&) At no point of the screen within 18 inches from the center shall the
velocity of the exhaust draft be less than 100 linear feet per minute.
3. All damaged wool or hair or fallen fleeces or skin, wool or hair, if of the
kinds named in the schedules, shall, when opened, be damped with a disin­
fectant and washed without being willowed.
4. No wool or hair of the kinds named in schedules B or C shall be sorted
except over an efficient sorting board, with mechanical exhaust draft, and
in a room set apart for the purpose, in which no work is carried on other
than sorting and the packing of the wool or hair sorted therein.
No wool or hair of the kinds numbered (1) and (2) in schedule A shall be
sorted except in the damp state and after being washed.
No damaged wool or hair of the kinds named in the schedules shall be sorted
except after being washed.
For the purpose* of this regulation, no sorting board shall be deemed to be
efficient unless it complies with the following conditions:
The sorting board shall comprise a screen of open wirework, and beneath
it at all parts a clear space not less than 3 inches in depth. Below the center
of the screen there shall be a funnel, measuring not less than 10 inches across
the top, leading to an extraction shaft, and the arrangements shall be such that
all dust falling through the screen and not carried away by the exhaust can
be swept directly into the funnel. The draft shall be maintained in constant
efficiency while the sorters are at work, and shall be such that not less than
75 cubic feet of air per minute are drawn by the fan from beneath each sort­
ing board.
5. No wool or hair of the kinds named in the schedules shall be willowed
except in an efficient willowing machine, in a room set apart for the purpose,
in which no work other than willowing is carried on.




ANTH RAX AS AN OCCUPATIONAL DISEASE---- APPENDIX B.

169

For the purpose of this regulation, no willowing machine shall be deemed to
be efficient unless it is provided with mechanical exhaust draft so arranged
as to draw the dust away from the workmen and prevent it from entering the
air of the room.
6. No bale of wool or hair shall be stored in a sorting room; nor any wool or
hair except in a space effectually screened off from the sorting room.
No wool or hair shall be stored in a willowing room.
7. In each sorting room, and exclusive of any portion screened off, there shall
be allowed an air space of at least 1,000 cubic feet for each person employed
therein.
8. In each room in which sorting, willowing, or combing is carried on, suit­
able inlets from the open air or other suitable source shall be provided and
arranged in such a way that no person employed shall be exposed to a direct
draft from any air inlet or to any draft at a temperature of less than 50° P.
The temperature of the room shall not, during working hours, fall below
50° F.
9. All bags in which wool or hair of the kinds named in the schedules has
been imported shall be picked clean and not brushed.
10. All pieces of skin, scab, and clippings or shearings shall be removed daily
from the sorting room and shall be disinfected or destroyed.
11. The dust carried by the exhaust draft from opening screens, sorting
boards, willowing or other dust-extracting machines and shafts shall be dis­
charged into properly constructed receptacles and not into the open air.
Each extracting shaft and the space beneath the sorting boards and opening
screens shall be cleaned out at least once in every week.
The dust collected as above, together with the sweepings from the opening,
sorting, and willowing rooms, shall be removed at least twice a week and
burned.
The occupier shall provide and maintain suitable overalls and respirators, to
be worn by the persons engaged in collecting and removing the dust.
Such overalls shall not be taken out of the works or warehouse, either for
washing, repairs, or any other purpose, unless they have been steeped over­
night in boiling water or a disinfectant.
12. The floor of every room in which opening, sorting, or willowing is car­
ried on shall be thoroughly sprinkled daily with a disinfectant solution after
work has ceased for the day, and shall be swept immediately after sprinkling.
13. The walls and ceilings of every room in which opening, sorting, or willow­
ing is carried on shall be limewashed at least once a year and cleansed at least
once within every six months, to date from the time when they were last
cleansed.
14. The following requirements shall apply to every room in which unwashed
wool or hair of the kinds named in the schedules, after being opened for sort­
ing, manufacturing, or washing purposes, is handled or stored:
(a)
Sufficient and suitable washing accommodation shall be provided out­
side the rooms and maintained for the use of all persons employed in such
rooms. The washing conveniences shall comprise soap, nailbrushes, towels,
and at least one basin for every five persons employed as above, each basin being
fitted with a waste pipe and having a constant supply of water laid on.
(&) Suitable places shall be provided outside the rooms in which persons
employed in such rooms can deposit food, and clothing put off during working
hours.
( c)
No person shall be allowed to prepare or partake of food in any such
room. Suitable and sufficient meal-room accommodation shall be provided for
workers employed in such rooms.




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BULLETIN OF TH E BUREAU OF LABOR STATISTICS,

{d) No person having any open cut or sore shall be employed in any such
room.
The requirements in paragraph (c ) shall apply also to every room in which
any wool or hair of the kinds named in the schedules is carded or stored.
15. Requisites for treating scratches and slight wounds shall be kept at hand.
16. The occupier shall allow any of H. M. inspectors of factories to take at
any time, for the purpose of examination, sufficient samples of any wool or hair
used on the premises.
DUTIES OF PERSONS EM PLOYED.

17. No bale of wool or hair of the kinds named in the schedules shall be
opened otherwise than as permitted by paragraph 1 of regulation 1, and no
bale of wool or hair of the kinds named in schedule A shall be opened except
after thorough steeping in water.
If on opening a bale any damaged wool or hair of the kinds named in the
schedules is discovered, the person opening the bale shall immediately report
the discovery to the foreman.
18. No wool or hair of the kinds named in schedule B shall be opened other­
wise than as permitted by regulation 2.
19. No wool or hair of the kinds named in the schedules shall be sorted other­
wise than as permitted by regulation 4.
20. No wool or hair of the kinds named in the schedules shall be willowed
except as permitted by regulation 5.
21. Every person employed in a room in which unwashed wool or hair of the
kinds named in the schedules is stored or handled shall observe the following
requirements:
(a) He shall wash his hands before partaking of food or leaving the premises.
(ft) He shall not deposit in any such room any article of clothing put off
during working hours. He shall wear suitable overalls while at work and shall
remove them before partaking of food or leaving the premises.
(£) If he has any open cut or sore, he shall report the fact at once to the
foreman and shall not work in such a room.
No person employed in any such room or in any room in which wool or hair
of the kinds named in the schedules is either carded or stored shall prepare or
partake of any food therein or bring any food therein.
22. Persons engaged in collecting or removing dust shall wear the overalls as
required by regulation 11.
Such overalls shall not be taken out of the works or warehouse, either for
washing, repairs, or any other purpose, unless they have been steeped overnight
in boiling water or a disinfectant.
23. If any fan, or any other appliance for the carrying out of these regula­
tions, is out of order, any workman becoming aware of the defect shall imme­
diately report the fact to the foreman.
SCHEDULE A .

(Wool or hair required to be steeped in the bale before being opened.)
1. Van mohair.
2. Persian locks.
3. Persian or so-called Persian (including Karadi and Bagdad), if not sub*
jeeted to the process of sorting or willowing.




A N T H R A X AS A N OCCUPATIONAL, DISEASE— A PP E N D IX B.

171

SCHEDULE B.

(Wool or hair required to be opened either after steeping or over an efficient

opening screen.)
Alpaca.
PeUtan.
East Indian cashmere.
Russian camel hair.
Pekin camel hair.
Persian or so-called Persian (including Karadi and Bagdad), if subjected to
the process of sorting or willowing.
SCHEDULE C.

{Wool or hair not needing to be opened over an opening screen, but required
to be sorted over a board provided with downward draft.)
All mohair other than Van mohair.
Note.

The danger against which these regulations are directed is that of anthrax—»
a fatal disease affecting certain animals, which may be conveyed from them
to man by the handling of wools or hairs from animals which have died of
the disease. The germs of the disease (anthrax spores) are found in the dust
attaching to the wool or in the excrement, and in the substance of the pieces
of skin, and may remain active for years. In this country and Australia
anthrax is rare, consequently there is little danger in handling wools from the
sheep of these two countries; but in China, Persia, Turkey, Russia, the East
Indies, and in many other parts of the world, the disease is common, and
infected fleeces or locks (which may not differ from others in appearance) are
often shipped to Great Britain. Hence, in handling foreign dry wools and hair,
the above regulations should be carefully observed. Greasy wools are com­
paratively free from dust, and therefore little risk is incurred in handling them.
The disease is communicated to man sometimes by breathing or swallowing the
dust from these wools or hair, and sometimes by the poison lodging in some
point where the skin is broken, such as a fresh scratch or cut, or a scratched
pimple, or even chapped hands. This happens more readily on the uncovered
parts of the body, the hand, arm, face, and most frequently of all, on the neck,
owing either to infected wool rubbing against the bare skin, or to dust from
such wool alighting on the raw surface. But a raw surface covered by clothing
,
is not free from risk, for dust lodging upon the clothes may sooner or later work
its way to the skin beneath. Infection may also be brought about by rubbing
or scratching a pimple with hand or nail carrying the anthrax poison. Use of
the nailbrush, and frequent washing and bathing of the whole body, especially
o f the arms, neck, and head, will lessen the chance of contracting anthrax.
The first symptom of anthrax is usually a small inflamed swelling like a
pimple or boil— often quite painless— which extends, and in a few days becomes
black at the center and surrounded by other “ pimples.” The poison is now
liable to be absorbed into the system, and will cause risk of life, which can be
avoided only by prompt and effective medical treatment in the early stage, while
the poison is still confined to the pimple. Hence it is of the utmost importance
that a doctor should be at onge consulted if there is any suspicion of infection.




172

BULLETIN OF TH E BUREAU OF LABOR STATISTICS.

GREAT BRITAIN: REGULATIONS FOR THE PROCESSES INVOLVING
THE USE OF HORSEHAIR FROM CHINA, SIBERIA, OR RUSSIA,
IN EFFECT APRIL 1, 1908.1
DEFINITIONS.

“ Material ” means tail or mane horsehair from China, Siberia, or Russia,
whether in the raw state or partially or wholly prepared, notwithstanding that
such preparation may have taken place in some country other than those named.
“ Disinfection” means {a) exposure to steam at a temperature not less than
212° F. for at least half an hour of material so loosened, spread out, or ex­
posed as to allow the steam to penetrate throughout; or ( b) exposure of material
to such disinfectant under such conditions of concentration and temperature of
the disinfectant, and duration and manner of exposure of the material to it, and
otherwise, as are certified to secure the destruction of anthrax spores in all
parts of all horsehair subjected to the process: Provided, That such a certificate
shall have no force unless and until (1) a copy of it has been submitted to the
secretary of state, and (2) a copy of it is kept in the register required under
regulation 1 : Provided further, That any such certificate may at any time be
disallowed by the secretary of state, either generally or with regard to a factory
or workshop in which anthrax has occurred.
“ Certified ” means certified by the director of a bacteriological laboratory
recognized by a corporation in the United Kingdom having power to grant
diplomas registrable under the medical acts, 1858 to 1905.
It shall be the duty of the occupier to observe Part I of these regulations.
It shall be the duty of all persons employed to observe Part II of these regu­
lations.
PART I.— DUTIES OF EMPLOYERS.

1. A register shall be kept containing the prescribed particulars2 of the
disinfection of all material.
2. Material which has not undergone disinfection shall not be stored except
in a room set aside for the purpose, in which no other horsehair shall be placed.
3. Material which has not undergone disinfection shall not be opened from
the bale or sorted except in a room set aside for the purpose, in which no other
horsehair shall be placed; nor shall any such material be opened from the bale,
except over or by the side of an efficient screen, or sorted except over an
efficient screen.
For the purposes of this regulation no screen shall be deemed to be efficient
unless it is provided with an exhaust draft so arranged that at every point
of the screen within 18 inches of the center the velocity of the exhaust draft
shall be at least 300 linear feet per minute.
4. No material shall be subjected to any manipulation other than opening or
sorting until it has undergone disinfection.
5. Every willowing and dust-extracting machine shall be covered over and
provided with efficient exhaust draft so arranged as to carry the dust away
from the worker.
T
6. The dust from the opening and sorting screens, and from the willow or
other dust-extracting machines, shall be discharged into furnaces or into
chambers so constructed as to intercept the dust.
7. Each extracting shaft and the space beneath the opening and sorting
screen shall be cleaned out at least once in every week.
1 G reat B rita in , H om e Office.
2 See appended sch ed ule, p. 1 7 4 ,




F a c to r y an d W o rkshops O rders, L ondon, 1 9 0 9 , p. 9 3 .

A N T H R A X AS A N O C CU PATIO N AL DISEASE— A PP E N D IX B.

173

8. All dust collected from the opening and sorting screens shall be burned.
9. There shall be provided and maintained for the use of persons employed
on material which has not undergone disinfection—
(a) Suitable overalls and head coverings, which shall be collected at the end
of every day’s work, and washed or renewed at least once every week, and
shall not be taken out of the works for any purpose whatever unless they have
previously been boiled for 10 minutes or have undergone disinfection after
last being used ; and
(b) A suitable meal room, separate from any workroom, unless the works are
closed during meal hours; and
(c) A suitable cloakroom for clothing put off during working hours; and a
suitable place, separate from the cloakroom and meal room, for the storage of
the overalls; and
( d) Requisites for treating scratches and slight wounds.
10. There shall be provided suitable respirators for the use of persons
employed in work necessitated by regulations 6, 7, and 8. Each respirator
shall bear the distinguishing mark of the worker to whom it is supplied, and
the filtering material shall be renewed after each day on which it is used.
11. There shall be provided and maintained in a cleanly state and in good
repair for the use of all persons employed on material which has not undergone
disinfection, a lavatory, under cover, with a sufficient supply of clean towels,
renewed daily, and of soap and nailbrushes, and with either—
(a) A trough with a smooth impervious surface, fitted with a waste pipe
without plug, and of such length as to allow at least 2 feet for every five such
persons, and having a constant supply of warm water from taps or jets above
the trough at intervals of not more than 2 feet; or
(b) At least one lavatory basin for every five such persons, fitted with a
waste pipe and plug or placed in a trough having a waste pipe, and having
either a constant supply of hot and cold water or warm water laid on, or (if
a constant supply of heated water be not reasonably practicable) a constant
supply of cold water laid on and a supply of hot water always at hand when
required for use by persons employed.
12. No person under 18 years of age shall be employed on material which has
not undergone disinfection.
13. No persons employed on material which has not undergone disinfection
shall be allowed—
(a ) To work having any open cut or sore; or
(b) To introduce, keep, prepare, or partake of any food or drink, or to­
bacco, in any room in which such material is stored or manipulated.
14. A cautionary notice as to anthrax, in the prescribed form, shall be kept
affixed with these regulations.
PART II.— DUTIES OF PERSONS EM PLOYED.

15. No person employed shall—
(a) Open, sort, or willow or otherwise manipulate any material except in
accordance with the foregoing regulations.
(b) Introduce, keep, prepare, or partake of any food or drink, or tobacco,
contrary to regulation 13 (&).
16. Every person employed on material which has not undergone disinfection
shall—
(a )
Wear the overall and head covering provided in pursuance of regula­
tion 9 (a) while at work, and shall remove them before partaking of food or




174

B U L L E T IN OF T H E B U REA U OF L A B 0K STATISTICS.

leaving the premises, and shall deposit in the cloakroom provided in pursuance
of regulation 9 (c) all clothing put off during working hours; and
(b) Wash the hands and clean the nails before partaking of food or leaving
the premises; and
(c) Report any cut or sore to the foreman, and until it has been treated,
abstain from work on any such material,
17. Every person employed shall wear the respirator provided in pursuance
of regulation 10 while engaged in work necessitated by regulations 6, 7, and 8.
18. If the arrangement for disinfection, or any fan, or any other appliance
for the carrying out of these regulations, appears to any workman to be out
of order or defective, he shall immediately report it to the foreman.

SC H ED U LE: PR OCESSES IN V O L V IN G TH E U S E OF HORSEHAIR, 1908.

By an order dated March 11, 1008, the particulars to be entered on the
register under regulation 1 of the order as to use of horsehair are to be :
With regard to each consignment of such horsehair received 111 the factory
or workshop—
1. Weight of material.
2. Date of receipt en the premises.
3. Country of origin.
4. Whether raw or partially or wholly prepared.
5. Method of disinfection.
And in the case of material disinfected on the premises—
6. Date of disinfection.
And in the case of material disinfected elsewhere than on the premises—
7. Name of person from whom the material was obtained.

ANTHRAX PREVENTION ACT, 1919.
A N ACT to co n tro l th e im p o rta tio n o f goods in fec te d or lik ely to be in fec te d w ith
a n th r a x , and to provide fo r th e d isin fe c tio n o f a n y su ch goods. [2 2 d J u ly , 1 9 1 9 .]

Be it enacted by the King’s most Excellent Majesty, by and with the advice
astd consent of the Lords spiritual and temporal, and Commons, in this present
Parliament assembled, and by the authority of the same, as follows:
1.
(1) His Majesty may by order in council make provision for preventing
the importation into the United Kingdom, either absolutely or except at any
specified ports and subject to any specified conditions as to disinfection and
otherwise, of goods infected, or likely to be infected, with anthrax (in this act
referred to as “ infected goods” ).
(2)
An order under this section may contain a declaration that goods of any
specified class which are of any specified origin, or are exported from or through
T
any specified country or place, are goods likely to be infected with anthrax,
and any such declaration shall be conclusive for all purposes.
<3) Any order made under this section may be revoked or varied by any
subsequent order,




A N T H R A X A S A N O C C U P A T IO N A L DISEASE— A PP E N D IX B .

175

(4 ) An order in council under this act may apply, as respects any goods
specified in the order, any o f the provisions (including penal provisions) o f the
customs (consolidation) act, 1876, or any act amending or extending that act,
with respect to goods w hereof the im portation is prohibited under those acts,
with such modifications as appear necessary or expedient, and in particular with
the substitution o f Secretary o f State for the commissioners o f customs and
excise, and o f persons appointed by the Secretary o f State for officers o f customs
and excise.
(5 ) In this section the expression “ sp ecified” means specified in an order
made under this section.
2.
(1 ) A Secretary o f State may provide, maintain, and carry on, or arrange
for the provision, maintenance, or carrying on, at such ports or other places in
the United Kingdom, as he thinks proper, the necessary w orks for the disin fec­
tion o f infected goods, and may make rules providing for the payment by im­
porters o f infected goods o f fees in respect o f the disinfection thereof, and in
respect o f services rendered in connection with such disinfection, and for the
recovery o f such payments.
(2 )
Any expenses incurred by the Secretary o f State in carrying this act
into effect, up to sueh an amount as the Treasury may approve, shall be d e­
frayed out o f moneys provided by Parliament.
S. This act may be cited as the anthrax prevention act, 1919.

F R A N C E : D E C R E E R E L A T IN G T O S P E C IA L H Y G IE N IC M E A S U R E S
F O R E S T A B L IS H M E N T S W H E R E T H E W O R K E R S A R E E X P O S E D
TO A N T H R A X IN F E C T IO N , 1913.
1.
In the establishments contemplated in section 65 o f Book I I o f the Labor
Code, where are handled in the raw state skins, fur, horsehair, hogs’ bristles,
wool, horns, bones, or other animal products liable to be infected w ith anthrax,
the principals, directors or works managers shall be required, irrespective o f
the general measures prescribed by the decree o f July 10, 1913,1 to adopt the
special measures o f protection and hygiene mentioned in the follow ing articles.
In regard to the application o f the present decree, such product or anim al
remains as have not undergone the treatment mentioned below -shall be consid­
ered as in the raw sta te :
Horsehair, hogs’ hair and b ristles: Stoving at 103*5 for one hour, or soaking
for two hours in boiling water, or bleaching.
S k in s: Tanning.
W ools: Industrial degreasing.
Bones and h orn s: Stoving at 103° for one hour or soaking for two hours in
boiling water, or treatment w ith pow erful antiseptics.
All other methods o f disinfection which the minister o f labor, after taking
the opinion o f the consultative committee for arts and manufactures, shall
recognize as equivalent, may also be allowed.
1

F o r te x t o f th is decree see B u lle tin o f th e In te r n a tio n a l L abor Office, V ol. IX , 1 9 1 4 ,

p. € 3 .




176

'

B U L L E T IN OF T H E BU REA U OF LABOR STATISTICS.

2. A physician appointed by the principal o f the establishment shall carry
out the follow ing inspections and make the required re p o rts; his remuneration
shall be at the expense o f the establishment.
As soon as it shall come to the knowledge o f principals, directors, or works
managers that a workm an is suffering either from a form o f pimple, cut,
abrasion, or crack which has not healed up after three days’ dressing in the
factory, they shall have him at once examined by the physician, who shall
prescribe the necessary treatment. The name and age o f the worker and
the work in which he was engaged, the origin o f the m aterials recognized as
liable to have caused the infection, as also the result o f the m edical examina­
tion, shall be entered in a special register.
Every establishment shall be provided w ith a “ first-aid ” box containing the
remedies and materials for dressing, as prescribed by ministerial order. This
box shall always be kept in good condition, and placed in an easily accessible
place.
3. The principals o f works, directors, or managers shall be required to pro­
vide the workers with impermeable aprons and legging overalls for all work in
which the body is liable to come in contact with the water used in the treatment
o f the products o f animal remains mentioned in section 1.
4. The follow ing industries shall be considered as dangerous within the mean­
ing o f section 5 hereunder, where m aterials are treated which have come from
districts indicated in an order o f the minister o f labor, after consultation with
the minister o f commerce and industry and the minister o f agriculture.
(1 ) The preparation o f horsehair.
(2 ) The plucking, washing, and sorting o f wools.
(3 ) Tawing, tanning, and furriery.
(4 ) The sorting and working up o f bones and horns.
The follow ing operations shall *also be regarded as dangerous within the
meaning o f the same section: The unpacking, manipulation, and other opera­
tions perform ed in a dry condition, before disinfection o f the m aterials enu­
merated in section 1, which have come from the regions indicated in the order
above referred to.
5. In those parts o f the establishment specially devoted to the carrying on
o f the industries or to the perform ance o f the dangerous operations defined
under section 4, the follow ing precautions shall be observ ed :
In the w orkroom s the flooring shall consist o f an impermeable covering or
o f a sectional paving which can be easily washed. The walls shall have a
coating which can be thoroughly wT
ashed, or shall be limewashed.
This limewash coating shall be renewed whenever necessary, and especially
when a case o f anthrax has occurred. The tables, benches, and seats, also the
floors and walls, shall be washed as often as may be necessary with a disinfect­
ing solution. The tools shall be subjected to frequent disinfection.
In the storehouses where the materials referred to in section 1 are kept,
every space tem porarily unoccupied shall be cleaned with a disinfectant.
In the case o f wool, horsehair, hogs’ hair and bristles, tlie handling shall
be done wherever possible in closed vessels.
As regards the material referred to in the preceding paragraph, the operations
w hich it is impossible to carry out in a closed vessel— such as the opening o f
bales and, if necessary, the beating— must be carried out under such conditions
as w ill allow o f the collection o f all the offal and its subsequent destruction.
The dressing and washing rooms for the use o f the workers shall be fitted up
outside the places where dangerous operations are carried on.




A N T H R A X AS A N O CCU PATIO N AL DISEASE---- A PP E N D IX B.

177

The said dressing and washing rooms shall be fitted w ith a sufficient num­
ber o f basins or taps, with an ample provision o f water and soap and a towel
fo r each worker, which latter shall be renewed at least once a week. They
shall, moreover, be provided with wardrobes or boxes which can be closed by
key or a padlock, and which are divided into tw o compartments, so that the
outdoor clothes may be kept separate from the w orking clothes.
In default o f a separate cupboard divided into two compartments, every
worker shall have at his disposal tw o clothes pegs on opposite sides o f the
dressing room, for the purpose o f receiving on one side his ordinary and on
the other side his w orking clothes. The clothes pegs shall be separated by a
space o f at least 30 centimeters [11.8 inches].
The workers shall be provided with overalls for handling materials in the
raw state. They shall also be provided with protections for the neck, for the
transport o f those materials which have to be carried on the shoulder. Un«
less impracticable, all raw m aterials shall be carried in carts or handbarrows.
6. The minister o f labor, by order issued on the report o f the industrial in­
spectors, and after consultation with the consultative committee o f arts and
manufactures, shall have power to grant to an establishment, for a fixed term,
relief from the whole or a portion o f the provisions o f section 5 (paragraphs
5 and 6) if it is recognized that the application o f these provisions is practically
impossible, and that the health o f the workers is insured under conditions at
least equal to those which are fixed by the present decree.
7. The principals, directors, or w orks managers shall be required to affix
in a conspicuous position o f the w orking premises—
(1 ) The text o f the present decree.
(2 ) Shop rules, imposing on the workers the follow ing du ties: That they
shall use the various w orking clothes and other w orking articles placed gratui­
tously at their d isp osa l; that they shall make use o f the dressing room and the
washstands referred to in section 5 (paragraphs 7, 8, and 9) ; make good use
o f the provisions for cleanliness whenever leaving the prem ises; and bring no
food into the workroom.
(3) A notice pointing out the dangers o f anthrax, as also the precautions to
be taken to avoid them, and the necessity o f the w orkers to make the declara­
tion indicated in section 2.
(4) The name and address o f the physician intrusted with the medical serv­
ice o f the establishment.
The terms o f the notice mentioned in the present section under (2 ) shall be
fixed by a m inisterial order.
G E R M A N Y : O R D E R C O N C E R N IN G T H E E Q U IP M E N T A N D O P E R A ­
T IO N O F H O R S E H A IR S P IN N IN G E S T A B L IS H M E N T S , O F SHOPS
W H E R E O T H E R A N IM A L H A IR A N D B R IS T L E S A R E M A N IP U ­
L A T E D , A N D O F B R U SH F A C T O R IE S , 1902.
GENERAL RULES..

1. The follow ing rules apply to all establishments where horse, cattle, and
goat hair and bristles or hair o f hogs are manipulated or spun into curled hair,
as w ell as to brush factories.
2. Imported animal hair and bristles must not be manipulated unless disin­
fected in the establishment where they are to be used.
D isinfection must be effected by one o f the follow ing m ethods:
(1 )
Exposing the materials for at least h alf an hour to a current o f steam
under a pressure o f 0.15 over atmospheric pressure.
141633°— B u ll. 267— 20-------12




178

B U L L E T IN OP T H E B U BEA U OP LABOB STATISTICS.

<2) B oiling the m aterials fo r at least a quarter o f an hour in a 2 per cent
solution o f permanganate o f potassium and then bleaching them in a 3 or 4
per cent solution o f sulphurous acid.
(3 ) B oiling them for at least tw o hours in water.
Other processes o f disinfection may be authorized by the im perial chancellor.
The higher administrative authorities may order that the disinfection pro­
vided in section 2, No. 1, be effected in a public disinfecting establishment if
there is one in the place where the factory is situated or in its immediate
vicinity.
S. The m anufacturer may be permitted to dispense with disinfection i f he
can prove, in conform ity with regulations to be issued by the central State
authorities, that the m aterials had already been disinfected according to the
above rules when he received them and that he has stored them separately
from nondisinfected material.
The m anufacturer may om it disinfection o f white bristles provided that he
bleaches them before they are being w orked up or i f he has received them
bleached (so-called French dressed bristles) and stored them separately from
other nondisinfected material.
4. The central adm inistrative authorities may authorize exemptions from the
rules in section 2 fo r m aterials w hich—
(1 ) According to previous experience can not be subjected to the disinfec­
tion prescribed in section 2 w ithout being exposed to considerable injury.
(2 ) Are proved to have been subjected abroad to treatment which is con­
sidered equivalent to disinfection in conform ity w ith the rules in force in the
German Empire.
The central administrative authorities must keep a register o f the cases and
reasons fo r which exem ptions are granted. It must also indicate in the cases
mentioned in paragraph (2 ) o f this section the kind o f treatment to w hich the
materials have been subjected abroad. A copy o f this register must be sub­
m itted annually, not later than February 1, to the central authority o f the
State.
5. The materials fo r which disinfection is required must, before disinfection,
he subjected only to operations required to ascertain their condition, to pre­
vent them from deteriorating, or to prepare them for disinfection, such as
unpacking, cutting the hair adhering to the tails, transporting to the disin­
fecting apparatus, tying o f the bristles in bundles, etc. Sorting is allowed only
so fa r as it is necessary for the separation o f hair which has to be subjected to
different processes o f disinfection.
6. Juvenile workers must not be employed either in disinfecting processes,
or on m aterials exem pted from disinfection in conform ity w ith section 4, para­
graph (1 ), nor are they allow ed to w ork in the processes specified in section 5.
7. The employer must see that workers who have skin sores, especially on
the neck, face, and hands, are not employed in the processes specified in section 6.
8. The employer must keep a register in w hich he must enter the stock o f
hair and bristles received by him in such a w ay that the quantity o f these mate­
rials, the seller and, if possible, also the place o f origin, the time at w hich they
were disinfected and the processes used, or the reason for w hich disinfection
was omitted become evident.
I f the disinfection took place in a public establishment, the certificates given
on that occasion must be collected, preserved, and produced whenever required
by the supervisory officers.
9. Supplies o f nondisinfected materials which are subject to disinfection
and those which are exempt from disinfection according to section 4, para­




A N T B B A X A S A N O CCU PATIO N AL DISEASE— A PP E N D IX B .

179

graph (1>, must be kept in. special locked rooms and may be taken to these
reams or removed from them only by passages and staircases which are not
used by workers occupied on disinfected or on dom estic materials. Disin­
fected or domestic goods must not be transported through those passages
and staircases.
The operations w hich must necessarily precede disinfection, disinfection
itself, and the manipulation o f m aterials exem pted from disinfection in ac­
cordance with section 4, paragraph (1 ) y must not take place in rooms where
disinfected or domestic m aterials are kept or manipulated.
The places where disinfected materials or those exempted from disinfection
according to section 4, paragraph (1 ). are kept .or manipulated, the entrance
w ays to those rooms, also the passages and staircases through w hich the mate­
rials o f this category are transported, must be kept constantly clean. In clean­
ing them care must be taken to make as little dust as possible. The sweepings
from , and the wrappings in w hich the nondisinfected materials arrived, must
be burned or disinfected (section 2, paragraph 2 ). These measures apply equally
to dust generated by, and refuse resulting from, the working up o f nondisin­
fected materials and to rubbish.
REGULATIONS FOR LARGE ESTABLISHMENTS.

10. In establishments regularly employing 10 or more workers, the floor of
the workshop must be solid and tight and must allow an easy removal o f dust
by washing. W ooden floors must be smoothly planed and water-tight.
The walls and ceilings, unless they are covered with a hard glazed surface
which allows washing or are oil painted, must be whitewashed at least once a
year.
In the construction o f new and the enlargement o f existing establishments,
measures must be taken that in new workroom s where operations generating
considerable dust are to be carried out, the number o f workers should be so
calculated that each w ill have at least 15 cubic meters [530 cubic feet] air
space.
11. W orkroom s must be completely aired for at least half an hour tw ice a
day, i. e., during the noon hour and after the close or before the beginning o f
work. During this time workers must not be allowed in the shops.
The floors o f rooms where w ork generating dust is carried on must be cleaned
at least once a day by washing. The work tables in these rooms must be washed
at least tw ice a week.
12. In establishments where horsehair is spun or otherwise prepared the
sorting and hackling must be done in special rooms separated from the others.
The dust generated and the rubbish must be gathered and removed.
13. Mixing, cleaning, and hackling machines (beating and w illow ing ma­
chines) must be covered and provided with effective exhaust drafts. The dust
must be collected in a special chamber, and i f it comes from nondisinfected
m aterials it must be burned.
14. The workers employed on the processes prelim inary to disinfection or in
disinfection itself or in the treatment o f m aterials exempted from disinfection
according to section 4, paragraph (1 ), must be provided at the employer’s
expense with w orking clothes and caps in sufficient number and o f proper
materials.
By issuing suitable regulations and providing supervision the employer must
see to it that the work clothes are used only by those workers to wham they
are assigned, and that during the time when they are not in use the work
clothes are kept in places designated fo r that purpose and disinfected at least




180

B U L L E T IN OF T H E B U REA U OF LABOR STATISTICS.

once a week. The employer must give to the workers mentioned in the first
paragraph o f this section the opportunity o f taking a warm bath at least tw ice
a week.
15. In a part o f the establishment, free from dust, a dressing and washing
room shall be kept for the w ork ers; also a lunch room if necessary. The lunch
room must be separated from the dressing room. These rooms must be kept
clean and free from dust, and during the cold season they must be heated. In
the lavatory the workers must be supplied with a sufficient quantity o f water,
soap, and towels, and with an adequate number o f places for keeping the clothes
w hich are taken off before beginning work.
16. The employer must issue for the w orkers manipulating the materials
mentioned in the first paragraph o f section 2 the follow ing r u le s :
(1 ) The w orkers must use the working clothes provided for them during
those operations for which these clothes are assigned.
(2 ) The w orkers must not bring any food into the workshops. They must
eat only outside o f these places.
(3 ) The w orkers are not allowed to enter the lunch rooms, to eat, or leave
the establishment, except after taking off the working clothes prescribed in the
first paragraph o f section 14 and carefully washing their faces, necks, hands,
and eyes.
In rules which are issued it must be stipulated that workers who violate the
above regulations in spite o f repeated warnings w ill be discharged without
notice before the expiration o f their time.
I f shop rules are issued for an establishment, the above regulations must be
included.
17. Sections 1-16, legibly written or printed, must be posted in each w ork­
shop, dressing room, and lunch room.
P R U S S IA : O R D E R R E L A T IN G TO T H E P R O P A G A T IO N O F A N T H R A X
T H R O U G H A N IM A L SK IN S, 1902.
INSTRUCTIONS W IT H REGARD TO THE DANGERS TO H E A LTH IN V O LVE D IN THE
M AN IPU LATIO N OF R A W FOREIGN SKINS.

Experience has shown that the traffic in raw skins and hides, especially
those o f foreign origin, involves danger to the health o f human beings and
animals. Researches have proved that some o f the raw skins (especially deer
and kipskins coming from America, East India, and China) were taken from
anthrax-infected animals. The cause o f the disease is contained in these skins
and hides in the form o f very resistant anthrax spores. The usual processes
to w hich the skins are subjected, such as drying, or treatment w ith salt, salt­
peter, or arsenic, do not destroy the spore. The dust which is generated during
sorting, packing, and transportation, and also during the opening o f the bales
and becomes m ixed with shed hair is the principal carrier o f the disease. The
particles o f dust and the hair, to which the anthrax spores adhere, are deposited
on the clothes and bodies o f persons near by, and enter the mouth, nose, ears,
etc. Even the smallest abrasion o f the skin may be instrumental in producing
infection. Danger lies in the manipulation o f raw materials and in the evil
habit o f removing with the finger nails dry crusts on the skins. The persons
employed on raw skins can carry infection to other places on their soiled
clothes, hair, hands, etc.
It has also shown that anthrax may be produced by the pollution o f fodder
and straw with particles o f dust and hair from imported raw skins by the
use o f tanbark refuse as bedding in stalls and passageways, and by the tending




A N T H R A X AS A N O CCU PATIO N AL DISEASE---- A PP E N D IX B.

181

o f animals by persons handling raw foreign hides. Even the use o f refuse
from tanneries for the purpose o f fertilizing pastures and fields, also the soaking
o f skins in rivers and similar waters, may lead to the propagation o f anthrax.
A reliable and practical process o f disinfection which does not injure the
skins is not known. F or the purpose o f minimizing the danger o f infection the
follow ing precautionary measures can be recommended, especially to persons
regularly engaged in the handling o f raw sk in s:
(1 ) Storage places for raw foreign hides should be situated in out o f the
way localities at considerable distance from dwellings and from stables. They
must be carefully fenced so that animals can not enter them.
(2 ) Sheds, etc., for the storage o f straw and fodder must not be used as
storage places or w orkroom s for the preparation o f raw hides.
(3) The generation o f dust must be avoided as much as possible during the
opening o f the bales, also during sorting, piling, packing, and other manipula­
tions o f sk in s; when necessary the skins should be sprinkled with water.
(4) The places where raw foreign hides are stored or worked up must be
carefully cleaned after they are u s e d ; they must be disinfected at proper
intervals.
(5) Tanbark used in the tanning, the hair and other refuse from the tan­
neries, and other remains, the straw, rags, cords, etc., which were used in pack­
ing the raw foreign hides, as well as the sweepings, must be either burned or
buried after disinfection.
(6) Persons having external wounds should n ot be allowed to manipulate
raw foreign hides.
(7 ) B efore leaving the w ork place persons occupied in handling raw foreign
hides must carefully clean their faces, arms, hands, hair, and beard.
(8) The storerooms, work places, etc., must be cleaned only by wet processes.
(9 ) A solution o f chloride o f lime (one part chloride o f lime and three parts
w ater) or a mixture o f sulphuric and carbolic acid (one part o f sulphuric acid,
two parts o f crude carbolic acid, and four parts o f w ater) are recommended as
disinfectants. These disinfectants should be also used on sweepings and other
refuse.
P R U S S IA :

R E G U L A T IO N S FO R T H E P R O T E C T IO N O F W O R K E R S
A G A IN S T T H E D A N G E R S O F A N T H R A X , 1910.

1. Raw sheep and goat skins, as well as dry imported raw skins, shall be
stored in separate storerooms, capable o f being locked, which are used for this
purpose only, and are not in direct communication with living rooms, stables or
rooms for storing fodder.
2. The storerooms shall be provided with floors made o f cement, asphalt or
other impervious material, the joints being perfectly tight. Premises which
have already been in existence may be used for a further period not exceeding
10 years, should they be provided with floors o f the nature referred to above.
The storerooms shall be cleaned at least once a week, by means o f damp
sawdust or damp tanbark, for instance. Storerooms shall be disinfected after
they have been w holly or partially emptied, by washing them with a solution o f
1 part fresh chloride o f lime in 20 parts water, in conform ity with the regula­
tion that the whole o f the storeroom shall be disinfected in this manner at least
once a year, but walls and ceiling only in so far as they have come in contact
with raw skins. The said whitewash shall not be removed for a space o f 24
hours at least.




182

B U L L E T IN O F 'T H E BU REA U OF LABOR STATISTICS.

R efuse and valueless packing m aterial (straw* bast, ropes, etc.) shall be
burned.
3. Raw sheep and goat skins, as w ell as dried im ported raw skins, shall be
handled w ith special care. Above all, care must be taken not to subject the said
skins to an unnecessary amount o f shaking and not to throw them about.
For the transport o f skins the use o f special contrivances, such as wagons
(trolley s), etc., is very strongly recommended.
W orkers shall not be allow ed to carry skins unless they have been provided
w ith protective hoods, w hich cover the head, neck, and shoulders; while they
must also be provided w ith a sufficient number o f smocks o f good quality when
handling dried foreign skins.
The employer shall insure that, by means o f suitable arrangements and
proper supervision, sm ocks and protective hoods are w orn only by those workers
to whom they have been handed for use, and that they are disinfected at once
after having been in use fo r one week. The said disinfection shall be effected
as the employer may direct, either by steaming at a pressure o f not less than
0.15 above atmospheric pressure, or by boiling fo r at least one hour.
4. W orkers who come in contact with raw sheep or goat skins or dried im­
ported raw skins shall have their attention drawn at the commencement o f
their employment to the dangers o f anthrax, to which they may be exposed, and
they shall be handed a copy o f the regulations fo r the prevention o f accidents,
and likewise instructions in regard to anthrax. The said instructions shall
further be posted up in the workrooms. The necessary number o f copies o f the
same w ill be placed at the disposal o f the employers by the association.
5. A part o f the works, as fa r as possible free from dust and suitable for the
purpose, shall be reserved fo r washing rooms and, wliere it is customary for
w orkers to take their meals w ithin the works, lunch rooms shall be provided.
The said lunch rooms shall be kept clean and free from dust, and shall be
heated during the cold season.
6. The employer shall also insure that any worker who exhibits symptoms
o f anthrax shall immediately place him self under medical treatment, and, fu r­
ther, that any workers suffering from anthrax shall be admitted to the hospital
indicated by the trade association.
7. W orkers w ho are engaged in w orking up raw sheep and goat skins, as also
dried imported raw skins, shall not be allowed to enter the lunch room, to take
any meals, or to leave the works, until they have divested themselves o f their
working clothes and have thoroughly washed the face, head, hair and beard,
Beck, hands, and arms.
Th e w orkers shall not be permitted to take beverages in open containers or
foodstuffs into the workroom . They shall likewise be forbidden to take meals
in the latter.
8. Should the w orker become aware o f an itching or burning sensation on the
head, or pain arising from a darkish pimple, which, although at first o f small
size, rapidly grows larger, he shall immediately inform the w orks management
and place him self under medical treatment or enter the hospital to which he
has been referred, since delay is dangerous and would probably lead to the
death o f th e worker.




IN D E X .

A.
A ge. (See N a tiv ity , a g e, sex, and co n ju g a l co n d itio n o f fa t a l cases, e tc .)
P a g e.
A g r icu ltu r e and o th er in d u str ie s in v o lv in g d irect c o n ta c t w ith a n im a ls --------- ---19
A g ricu ltu re, D e p a r tm e n t of, and D ep a rtm en t o f T rea su ry , jo in t order No. 2 _______1 4 9 - 1 5 7
A g ricu ltu re, D ep a rtm en t o f B ureau o f A nim al In d u stry . S p ecial order 2 5 6 _______ 1 5 7 - 1 6 0
A g ricu ltu re, p rev en tio n o f a n th r a x in, le g is la tio n in regard to, U n ited S t a te s ----1 0 2 , 1 0 3
A n im a l p ro d u cts lia b le to be in fec te d w ith a n th r a x , im p o rts of, 1 9 1 0 to 1 9 1 5 -----104
A n im a l sk in s, p ro p a g a tio n o f a n th r a x th ro u g h , te x t o f order r e la tin g to, P r u ssia ,
1 9 0 2 ________________________________________________________________________________ 1 8 0 , 1 8 1
A n im a l su b ject to a n th r a x , a n d c o u n tries w h ere th e d ise a se is p r e v a le n t-----------12
A n th ra x , ca ses o f :
B rad ford (E n g la n d ) and D is tr ic t A n th ra x I n v e stig a tio n B oard, 1 9 0 6 to 1 9 1 4 _
121
F ra n ce, 1 9 1 0 to 1 9 1 2 ______________________________________________________________
124
G erm any, Im p eria l H e a lth Office, 1 9 1 0 to 1 9 1 2 --------------------------------------123
G reat B rita in , c h ie f fa c to r y in sp ector, by in d u stries, 1 9 0 0 to 1 9 1 8 ____________
120
G reat B rita in , w orkm en’s com p en sation act, ca ses com p en sated under, 1 9 0 8
to 1 9 1 4 __________________________________________________________________________
133
H ollan d , 1 8 9 8 to 1 9 1 1 ____________________________________________________________
124
I ta ly , 1 8 9 0 to 1 9 0 4 ____________________________________________________________ _
125
M a ssa c h u setts h o sp ita l, by o ccu p a tio n s, J u n e 2 7 , 1 8 8 1 , to A pril 2 6 , 1 9 1 6 _______
43
M a ssa c h u setts w o rk m en ’s c o m p en sa tio n la w , c la im s filed u n d er____________ ___
109
N ew York S ta te D e p a r tm e n t o f Labor, under o ccu p a tio n a l d isea se rep ortin g
law , Septem ber, 1 9 1 1 , to M arch, 1 9 1 6 ______________________________________ ___
37
P h ila d e lp h ia h o sp ita l, d u ra tio n o f illn e s s am o n g 3 2 e a se s in a _________________
41
P h ila d elp h ia h o sp ita l, J a n u a ry 1, 1 9 0 9 , to A pril 3 0 , 1 9 1 6 _______________________
39
126
R u s sia _______________________________________________________ _______________________
T a n n in g and le a th e r m a n u fa ctu rin g e sta b lish m e n ts ( 1 9 ) _______________________ 4 4 , 4 5
U n ited S ta te s r eg istr a tio n area, 1 9 1 0 to 1 9 1 7 __________________________________ 5 8 - 6 5
A n th ra x in E urope (C h ap ter V ) ---------:__________________________________________1 1 5 - 1 3 4
A n th ra x in U n ited S ta te s (C h a p ter I V ) ________ _____________________________________2 5 - 1 1 4
B.
B a cillu s o f a n th r a x and it s spore, d iscovery, c h a r a cter istic s, etc., o f --------------- 6 , 1 0 - 1 2
B elgium , w ool, h air, a n d b r istle s in d u stry , p r o te c tiv e le g is la tio n in ____________, __
_
130
B ich lo rid e o f m ercu ry so lu tio n , d isin fec tio n o f h id es by, T reasu ry D ep artm en t
req u irem en ts a s t o -------------------------------------------------------------- 1 0 5 - 1 0 8 , 1 5 7 , 1 5 8
B o ilin g .
(See D is in fe c tio n .)
B ones, h o o fs, and horns, d is in fe c tio n of, jo in t order No. 2 _______________________ 1 51 , 1 5 9
B rad ford (E n g la n d ) and D is tr ic t A n th ra x In v e stig a tio n B o a rd ___________________ 1 1 5 , 1 1 6
B ra d fo rd (E n g la n d ) and D is tr ic t A n th ra x I n v e stig a tio n B oard, c a se s in w ool in ­
d u str y rep orted by, 1 9 0 6 to 1 9 1 4 ___________________________________________________
121
B r istle s , im p o rts of, in to th e U n it e d S ta te s, 1 9 1 0 to 1 9 1 5 __________________ ________
104
C.
C hina or W e st C oast o f In d ia , h id es and sk in s im p orted from , te x t o f r eg u la tio n s
g o v ern in g , G reat B rita in , 1 9 0 1 ______________________________________________________
167
C hina, Siberia, or R u ssia , h o rseh a ir from , p ro cesses in v o lv in g u se of, te x t o f regu­
la tio n s g o v ern in g , G reat B rita in , 1 9 0 8 _________________________________________ _ 1 7 2 - 1 7 4
C om p en sation fo r a n th r a x a s an in d u str ia l in ju ry , E u ro p e________________________ 1 3 2 - 1 3 4
C om p en sation fo r v ic tim s o f o ccu p a tio n a l a n th ra x , le g is la tio n as to, U n ited S ta te s _ 1 0 9 - 1 1 4
C o n d itio n s o f so il a nd te m p er a tu re fa v o ra b le to th e d ev elop m en t o f a n th r a x _______
13
C onju gal c o n d itio n . (See N a tiv ity , age, sex, and co n ju gal co n d itio n o f fa t a l cases,
etc .)
1>.
D ea th s, recorded c a u ses of, r e g istr a tio n area, U n ite d S ta te s, 1 9 1 0 to 1 9 1 7 ________ 5 8 - 6 5
D e a th s.
(See also F a t a l cases, e tc .)
D ela w a re, m orocco-leather cen ter, ex p erien ce in ___________________________________ 3 2 - 3 5
D ela w a re, q u a ra n tin e p la ca rd s and n o tice to em p lo y ees in ----------------------------34
D e v o to , P rof. L., and F. M a ssa relli, reco m m en d a tio n s by, fo r con trol an d p reven ­
tio n o f a n th r a x _____________________________________________________________________
147
D ia g n o sis, early, im p o rta n ce and d ifficu lties of, e tc _________________________________2 6 — 8
2
D is in fe c tio n :
B ich lo rid e o f m ercury so lu tio n , T rea su ry D e p a r tm e n t req u irem en ts- 1 0 5 - 1 0 8 , 1 5 7 , 1 5 8
B o ilin g , g en era l rules, G erm any, 1 9 0 2 ________________________________________ 1 7 7 , 1 7 8
B o ilin g , in w a te r ; in p erm a n g a n a te o f p o ta ssiu m s o lu tio n ____________________
135
F o rm a ld eh y d e as a germ icid e for w ool, rep ort o f B rad ford (E n g la n d ) and D is ­
tr ic t A n th ra x I n v e stig a tio n B o a rd _________________________________________ 1 3 5 , 1 3 6
F ra n ce, sp ecia l h y g ien ic m easures, te x t o f decree r e la tin g to, 1 9 1 3 _________ 1 7 5 - 1 7 7
Germ any, h o rseh a ir-sp in n in g e sta b lish m e n ts, te x t o f order concerning, 1 9 0 2 1 7 7 — 8 0
1
G reat B rita in , g en era l reg u la tio n s, te x t of, 1 9 0 5 , 1 9 0 8 _____________________ 1 6 8 - 1 7 4
M a ssa c h u setts, su g g e ste d rules and r e g u la tio n s _____________________________ 1 6 2 , 1 6 3




183

184

IN D E X .

D is in fe c tio n — C oncluded.
Page.
P o ta ssiu m , p e r m a n g a n a te of, b o ilin g in so lu tio n o f--------------------------------135
P roblem of, p resen t s ta tu s o f (C h a p ter V I ) --------------------------------------_ 1 3 5 - 1 4 0
P r u ssia , te x t o f reg u la tio n s, 1 9 0 2 , 1 9 1 0 -------------------------------------------- 1 8 0 — 8 2
1
S c h a tte n fr o h m eth od of, fo r h id es and s k in s --------------------------------- 1 3 8 — 4 0 , 1 6 2
1
Seym ou r-Jones m eth od of, for h id e s a n d s k in s ------------------------------- 1 3 8 , 1 3 9 , 1 6 2
S tea m s te r iliz a tio n , effect of, on w o o l____________________________________________
136
U n ited S ta tes, jo in t order No. 2, D ep a rtm en ts o f T reasury and A g r icu ltu r e-----1 4 9 - 1 5 7
D u r a tio n o f illn e s s in 3 2 ca ses o f a n th r a x , P h ila d e lp h ia h o s p ita l---------------------41
E.

E n glan d , w ool, hair, and b r istle s in d u stry , p r o te c tiv e le g is la tio n in ______________ _ 1 2 7 , 1 2 8
E n glan d .
(See also G reat B r ita in .)
E urope, a n th r a x in (C h a p ter V ) ------------------------------------------------------------1 1 5 - 1 3 4
F.

F a c to r y in sp ecto r, ch ief, a n th r a x c a se s rep o rted to, G reat B r ita in , 1 9 0 0 to 1 9 1 3 __
120
F a t a l c ^ se s , p la ce and d a te of, in r e g istr a tio n area, U n ited S ta te s, 1 9 1 0 to 1 9 1 7 — 5 8 — 5
6
F a ta l c a se s rep orted in r e g istr a tio n area, U n ited S ta te s, 1 9 1 0 to 1 9 1 7 , histto r ie s, e t c --------------------------------------------------------------------------------------- 4 6 - 9 8
F a ta l ca ses to to ta l nu m ber o f cases, probable r a tio of, U n ite d S t a te s ------------ - 9 8 - 1 0 0
F o r m a ld e h y d e a s a g erm icid e fo r w o o l, rep o rt o f B ra d ford (E n g la n d ) an d D is tr ic t
A n th ra x In v e stig a tio n B o a rd _____________________________________________________ 1 3 5 , 1 3 6
F rance:
C ases reported, 1 9 1 0 to 1 9 1 2 _____________________________________________________
124
E sta b lis h m e n ts w h e r e w o rk ers a re e x p o sed to a n th r a x in fec tio n , te x t o f decree
a ffectin g , 1 9 1 3 _______________________________________________________________ i 1 7 5 - 1 7 7
M a n u fa ctu r er s’ A sso c ia tio n fo r P r e v e n tio n o f In d u s tr ia l A ccid en ts, a c tiv it y o f.
117
W ool, h air, and b r is tle s in d u str y , p r o te c tiv e le g is la tio n ------------------------- 1 2 9 , 1 3 0
G.
G erm any :
C om pulsory rep o rtin g la w s and r es u lta n t d a ta ______________________________ 1 2 2 - 1 2 4
E m p lo y ers’ M u tu al T ra d e A sso c ia tio n , a c tiv it y o f____________________________1 1 6 , 1 1 7
H orseh a ir-sp in n in g e sta b lish m e n ts, a n d h air, b r istle s, and brush fa c to r ie s,
e q u ip m en t and o p era tio n of, t e x t o f o rder g o v ern in g, 1 9 0 2 _______________ 1 7 7 - 1 8 0
Im p eria l H e a lth Office, a n th r a x ca ses rep orted to, 1 9 1 0 to 1 9 1 2 ________________
123
W ool, h air, and b r istle s in d u str y , p r o te c tiv e le g is la tio n ______________________1 2 8 , 1 2 9
G erm any. (See also P r u s s ia .)
G lue stock, cer tific a tio n and d isin fe c tio n , jo in t order No. 2 ______________________1 5 0 , 1 5 1
G o v ern m en ta l in v e s tig a tio n , E u r o p e ________________________________________________1 1 8 , 1 1 9
G reat B r ita in :
A n th ra x p rev en tio n act, 1 9 1 9 _________________________________________________ 1 7 4 , 1 7 5
C om pulsory rep o rtin g la w s and r e s u lta n t d a ta _______________________________ 1 1 9 — 2 2
1
F a c to r y in sp ecto r, ch ief, a n th r a x c a se s rep orted to, 1 9 0 0 to 1 9 1 3 __________ ___
120
H id es and sk in s im p o rted from C hina or W e st C oast o f In d ia , te x t o f r eg u ­
la tio n s g o v ern in g , 1 9 0 1 _________________________________________________ _______
167
H o rseh a ir from C hina, Sib eria, or R u ssia , te x t o f r e g u la tio n s g o v e rn in g u se
of, 1 9 0 8 ________________________________________________________________________ 1 7 2 - 1 7 4
R eco m m en d a tio n s o f d is in fe c tio n su b co m m ittee o f d e p a r tm en ta l c o m m ittee to
in q u ire a s to p r e ca u tio n s fo r p r e v e n tin g d a n g er o f in fe c tio n by a n th r a x __1 4 3 — 4 5
1
W ool, g o a t hair, and cam el hair, so rtin g , w a sh in g , etc., of, te x t o f reg u la tio n s
go v ern in g , 1 9 0 5 ------------------------------------------------------------------------ 1 6 8 - 1 7 1
W orkm en’s co m p en sa tio n a c t, a n th r a x ca ses co m p en sated under, 1 9 0 8 to
1 9 1 4 __________________________________________________________________________ _
133
G reat B r ita in .
(See also E n g la n d .)
H.

H air, b r istle , and brush fa c to r ie s, te x t o f order con cern in g eq u ip m en t an d oper­
a tio n of, G erm any, 1 9 0 2 ___________________________________________________________ 1 7 7 - 1 8 0
H air, b ristles, an d p ig s ’ w ool, d isin fec tio n of, su g g ested ru les and r eg u la tio n s,
M a ssa ch u setts, 1 9 1 6 __________________________________________________________________
162
H id es and sk in s :
D isin fe c tio n by b ichlorid e o f m ercury so lu tio n , T reasu ry D ep a rtm en t req u ire­
m en ts as t o __________________________________________________________ 1 0 5 - 1 0 8 , 1 5 7 , 1 5 8
D isin fe c tio n of, jo in t order No. 2 _____________________________________________ 1 5 7 , 1 5 8
G reat B rita in , te x t o f r e g u la tio n s g o v e rn in g h id es and sk in s im p orted from
C hin a or W est C o a st o f In d ia , 1 9 0 1 ------------------------------------------------167
Im p o r ts of, in to th e U n ited S ta te s, 1 9 1 0 to 1 9 1 5 -------------------------------------104
L eg isla tio n , p ro te c tiv e , co v erin g th e in d u stry , E u ro p e_________________________ 1 3 0 - 1 3 1
M a ssa c h u setts, ru les a nd r e g u la tio n s su g g e ste d a s to d is in fe c tio n o f ------------.1 6 2
H isto r ie s, in d iv id u a l, o f fa t a l ca ses rep o rted in r e g istr a tio n area, U n ited S ta te s,
1 9 1 0 to 1 9 1 7 _________________________________________________________________________ 6 6 - 9 8
H isto r y and g en era l d e scrip tio n o f a n th r a x (C h a p ter I ) _____________________________
9— 3
1
A n im a ls su b ject to a n th r a x , and co u n trie s w h ere d ise a se is p r e v a le n t_________
12
B a c illu s a n d its spore, c h a r a c te r is tic s o f __________________________________________1 1 , 1 2
B a cillu s, d isco very o f______________________________________________________________
10
C o n d itio n s o f so il and tem p era tu re fa v o ra b le to d evelop m en t o f a n th r a x _______
13
D isea se, ea rly stu d ies o f th e ______________________________________________________
9
In fectio n , m od es o f _______________________________________________________________
13
H ollan d, a n th r a x cases reported in, 1 8 9 8 to 1 9 1 1 _____________________________________
124
H ollan d, com pu lsory rep o rtin g la w s and r e su lta n t d a ta _________________________
125
H o rse and oth er a n im a l h a ir m a n u fa ctu red , im p o rts of, in to th e U n ited S ta te s,
1 9 1 0 to 1 9 1 5 _________________________________________________________________________
104




IN D EX

185

Page.
H o r se h a ir from C hina, S ib eria, or R u ssia , u se of, t e x t o f r eg u la tio n s govern in g,
G reat B r ita in , 1 9 0 8 _______________________________________________________________ 1 7 2 - 1 7 4
H o rseh a ir-sp in n in g e sta b lish m e n t, eq u ip m en t and o p era tio n o f, te x t o f order con­
cerning, G erm any, 1 9 0 2 -------------------------------------------------------------------- 1 7 7 - 1 8 0
H o rseh a ir w orkers, p e rso n a l p r e ca u tio n s of, te x t o f r e g u la tio n s govern in g, G reat
B rita in , 1 9 0 8 _____________________________________________________________________ 1 7 3 , 1 7 4
H u n g a ry , w ool, h air, an d b r istle in d u str y in, p r o te c tiv e le g is la tio n ---------------------130
H y g ie n ic m easures, sp ecia l, a ffec tin g e sta b lish m e n ts w h ere w ork ers a r e exposed to
a n th r a x in fec tio n , te x t o f decree r e la tin g to, F ra n ce, 1 9 1 3 -------------------------1 7 5 - 1 7 7
I.
Im p o r ts o f a n im a l p ro d u cts lia b le to be in fec te d w ith a n th ra x , 1 9 1 0 to 1 9 1 5 -------104
In d u str ie s affected (C h a p ter I I I ) -------------------------------------------------------- ---- 1 9 - 2 3
56
In fa n ts, fa t a l c a se s rep orted of, r e g istr a tio n area, U n ited S ta te s, 1 9 1 0 to 1 9 1 5 ___
I n fe c tio n :
A n im a l h a ir a nd b r istle in d u str y , risk o f ------------------------------------------- 2 0 , 2 1
H orn and bone in d u stry , risk o f --------------------------------------------------------22
L ea th er in d u stry , risk o f ------------------------------------------------------------------ 19, 2 0
13
M odes o f ----------------------------------------------------- -------------------------------N o n o c c u p a tio n a l---------------------------------------------------------------------------23
T ra n sp o rta tio n in d u stry , risk o f --------------------------------------------------------22
W ool in d u stry , risk o f --------------------------------------------------------------------- 2 1 , 2 2
I n te r n a tio n a l A sso c ia tio n for L abor L eg isla tio n , subcom m ittee of, recom m enda­
tio n s o f ____________________________________________________________________________ 1 4 1 — 4 3
1
I n te r n a tio n a l o r g a n iz a tio n s and congresses, a c tiv it y of, E u rop e----------------------118
I ta ly , a n th r a x ca ses rep orted in, 1 8 9 0 to 1 9 0 4 --------------------------------------------125
I ta ly , com p u lsory rep o rtin g la w s an d r e s u lta n t d a ta -----------------------------------1 2 5 , 1 2 6
L.
L e g isla tio n , p ro tectiv e, in E u ro p e-----------------------------------------------------------1 2 6 - 1 3 1
L eg isla tio n , U n ited S t a te s ------------------------------------------------------------------- 1 0 0 — 1 4
1
L o ca lity .
(See Place, etc.)
M.
M an u factu re an d trade, p rev en tio n o f a n th ra x in. le g isla tio n in regard to, U n ited
S t a t e s _____________________________________________________________________________ 1 0 4 - 1 0 8
M a ssa c h u setts :
B oard o f L abor and In d u str ie s, ru les and reg u la tio n s su g g ested by, 1 9 1 6 ___1 6 1 - 1 6 4
H o sp ita l, c a ses on record in a -----------------------------------------------------------4 1 - 4 3
W orkm en’s c o m p en sa tio n law ,, c la im s filed un der, on a cco u n t o f a n th r a x , th ree
y e a rs en d in g J u n e 3 0 , 1 9 1 5 _ ,__________________________________* -----------------109
M a ssa relli, F., and P ro f. L. D ev o to , reco m m en d a tio n s by, for c o n tr o l an d p reven ­
tio n o f a n th r a x -------------------------------------------------------------------------------147
M eats, packed in stra w , import, from c er ta in co u n trie s prohib ited, jo in t order No. 2 _
153
1
M ed ical a sp e cts o f hu m an a n th ra x , sym ptom s, tr e a tm e n t, etc. (C h ap ter I I ) _____ 1 5 — 8
M ilan ( I t a ly ) L abor C linic, a c tiv it y o f -------------------------------------------------- 1 1 7 , 1 1 8
M orocco-leather cen ter, in D elaw are, experien ce o f__________________________________ 3 2 - 3 5
N.
N a tiv ity , age, sex, and co n ju gal co n d itio n o f fa t a l c a se s reported in r eg istr a tio n
area, U n ited S ta te s, 1 9 1 0 to 1 9 1 7 -------------------------------------------------------- 5 7 — 5
6
N ew J ersey o ccu p a tio n a l d isea se rep o rtin g law , ca se s reported u n d er _______________ 3 7 , 3 8
N ew York :
O ccu p a tio n a l d ise a se rep o rtin g la w , c a se s rep orted u n d er_______________________3 5 — 7
3
S ta te I n d u s tr ia l C om m ission, r eco m m en d a tio n s________________________ ,_____ 1 6 4 , 1 6 5
N ew Y ork C ity r eg u la tio n s g o v e rn in g p rep a rin g th e s k in s o f a n im a ls ____________
166
N o n o c c u p a tio n a l a n t h r a x _____________________________________________________________
23
O.
O ccupations rep orted in a n th ra x cases :
A rm y c o o k ________________________________________________________________________
55
B arb ers and h a ir d r e sse rs________________________________________________________
55
B r istle and brush, w orkers._______________________________________________________
53
C ustom s w e ig h in g _________ _______________________________________________________
52
F a r m in g and r a n c h in g ____________________________________________________________ 5 0 , 51
F r e ig h t h a n d lin g __________________________________________________________________ 5 2 , 5 3
H air w o rk in g and w e a v in g _______________________________________________________ 5 3 , 5 4
H ide and skin w o rk ers____________________________________________________________
43
H o u sek eep in g ______________________________________________________________________
56
L aborers___________________________________________________________________________
55
* L iv e r y m e n _____________________________________________________________________ “ __
54
L o n g sh o re w o r k ______________ ____________________________________________________5 1 . 5 2
M u sicia n ___________________________________________________________________________
55
P a p er m a k in g _________________________________________________ __ _________________
54
T a n n in g and le a th e r m a n u fa ctu rin g , v a rio u s o ccu p a tio n s in ___________________ 4 4 , 4 5
T a n n in g , U n ited S t a te s ___________________________________________________________4 9 , 5 0
T r a n sp o rta tio n w o rk ers___________________________________________________________
43
T ru ck d r iv in g _____________________________________________________________________
52
V e te rin a ry su r g er y ________________________________________________________________
54
W ool a n d h a ir w o r k e rs___________________________________________________________
43
W ool w a sh in g and so r tin g _ _ _ ____________________________________________________
54
P.
P age, C. H. W ., reco m m en d a tio n s by, fo r co n tro l an d p reven tion o f a n th r a x ____ 1 4 5 , 1 4 6
P age, C. H. W ., recorded ca ses o f hu m an a n th r a x in Ita ly , 1 8 9 0 to 1 9 0 4 __________
125
P e n n sy lv a n ia in fe c tio u s d ise a se r ep o rtin g law , ca ses rep orted u n d er_______________ 3 8 , 3 9




186

IN D E X .

P e r so n a l p r e ca u tio n s o f w o r k e r s :
P age.
G rea t B rita in , h id es and skins, r e g u la tio n s fo r h a n d lin g -------------------------167
G rea t B r ita in , h o rseh a ir, p ro cesses in v o lv in g u se o f_________________________ 1 7 3 , 1 7 4
G reat B rita in , w ool, g o a t hair, a n d cam el h a ir ___________________________________
170
M a ssa c h u setts, su g g ested ru les and r e g u la tio n s _________________________ _____ 1 6 3 , 1 6 4
N ew York, r eco m m en d a tio n s______________________________________________________
165
P h ila d e lp h ia h o sp ita l, cases on record in a _________________________________:_________ 3 9 — 1
4
P la c e and d a te o f fa ta l cases, r eg istr a tio n area, U n ited S ta te s, 1 9 1 0 to 1 9 1 7 _______5 8 - 6 5
P o ta ssiu m , p erm a n g a n a te of, d isin fec tio n by b o ilin g in so lu tio n o f __________________
135
P r e v e n tio n a n d control o f a n th r a x :
D evoto, P rof. L., and P. M assarelli, recom m en dation s by_______________________
147
P rance, te x t of r e g u la tio n s_____________________________________________________ 1 7 5 - 1 7 7
G erm any, te x t o f r eg u la tio n s---------------------------------------- ---------------- 1 7 7 - 1 8 0
G reat B rita in , te x t o f r e g u la tio n s _____________________________________________ 1 6 7 - 1 7 5
I n te r n a tio n a l A sso c ia tio n for L abor L eg isla tio n , su b com m ittee of, recom ­
m e n d a tio n s o f_________________________________________________________________ 1 4 1 - 1 4 3
L e g isla tio n in U n ited S t a te s __________________ _______________________________ _ 3 0 2 - 1 0 8
M a ssa ch u setts, ru les and r e g u la tio n s su g g ested b y___________________________1 6 1 - 1 6 4
P age, C. H. W., r eco m m en d a tio n s b y__________________________________________1 4 5 , 1 4 6
P r u ssia , te x t o f r eg u la tio n s _____________________________________________________ 1 8 0 - 1 8 2
P r u ssia , p ro p a g a tio n o f a n th r a x th ro u g h a n im a l sk in s in, te x t o f order r e la t­
in g to, 1 9 0 2 ---------------------------------------------------------------------------------- 1 8 0 , 1 8 1
P r u ssia , p r o te c tio n o f w orkers a g a in s t a n th r a x in, te x t of r e g u la tio n s for, 1 9 1 0 - 1 8 1 , 1 8 2
P r u ssia .
(See also G erm any.)
P u b lic H e a lth Service. A m en d m en t No. 6 to in te r s ta te q u a ra n tin e r eg u la tio n s, 1 9 1 6 160
P u b lic H e a lth S ervice. C ircu lar le tte r to S ta te and lo c a l a u th o r itie s _________ _____
148
Q.
Q u a ra n tin e a n d v a c c in a tio n o f farm a n im a ls __________________________________________
Q u a ra n tin e p la ca rd s a n d n o tic e to em ployees, D e la w a r e _____________________________

103
34

R.
R e g u la tio n s for th e co n tro l o f a n th r a x . (See P r e v e n tio n and con trol o f a n th r a x .)
R ep o rtin g , com pu lsory, le g is la tio n in regard to, U n ite d S t a te s ____________________ 1 0 0 - 1 0 2
R ep o rtin g , sy ste m a tic , a n d r e s u lta n t d a ta , E u ro p e_________________________________ 1 1 9 - 1 2 6
R u ssia , ca ses of a n th r a x _______________________________________________________________
126
R u ssia .
(See also C hina, Sib eria, or R u ssia , h o rseh a ir from , e tc .)
S.

S a n ita tio n o f w orksh ops, recom m en dation s. N ew Y ork_______________________________
165
S a n ita tio n o f w orkshops, su g g e ste d ru les an d reg u la tio n s, M a ssa ch u setts, 1 9 1 6 ____
163
S a n ita tio n o f w orksh ops, t e x t o f order co n cern in g , G erm any, 1 9 0 2 ______________ 1 7 9 , 1 8 0
S c h a tte n fr o h m eth od o f d isin fe c tio n , fo r h id es an d s k in s ----------------------- 1 3 8 , 1 4 0 , 1 6 2
S e r u m s __________________________________________________________________________________
JL8
S ex o f a n th r a x ca ses rep orted , in F ra n ce, and in G erm any, 1 9 1 0 to 1 9 1 2 ___r____ 1 2 3 , H:4
Sex.
( See also N a tiv ity , age, sex, and co n ju g a l co n d itio n o f fa t a l cases, e tc .)
S eym ou r-Jones m eth od o f d is in fe c tio n fo r h id es and s k in s ___________________ 1 3 8 , 1 3 9 , 1 6 2
Sib eria.
(See C hina, S ib eria, or R u ssia , h o rseh a ir from , e tc .)
S tea m s te r iliz a tio n , effect of, on w o o l----------------------------- ---------------------------136
S y m p to m s o f hu m an a n th r a x ------------------------------------------------------- 1 5, 16, 1 6 4 , 1 7 1
T.
T a n n ers and le a th e r m a n u fa c tu r e r s ( 1 9 ) , c a se s rep o rted b y ----------------------------- 4 4 , 4 5
T rad e a nd m a n u fa ctu re, p r e v en tio n o f a n th r a x in, le g is la tio n in regard to.
U n ited S t a te s ______________________________________________________________________ 1 0 4 - 1 0 8
T reasu ry, D ep a rtm en t of, and D ep a rtm en t o f A gricu ltu re, jo in t order No. 2 ------ 1 4 9 - 1 5 7
T re a tm en t o f hu m an a n th r a x __________________________________________________________ 1 6 — 8
1
U.
U n ited S ta te s, a n th r a x in (C h a p ter I V ) ---------------------------------------------------2 5 - 1 1 4
V.
V a c cin a tio n and q u a ra n tin e o f fa rm a n im a ls------------------------------------------------

103

W.
W ool and h air, d isin fe c tio n of, jo in t order No. 2 ------ _------------------------------ 1 5 1 , 1 5 2
W ool, g o a t h a ir, and cam el h air, so rtin g , w a sh in g , com bing, etc., of, te x t o f reg u ­
la tio n s g o v ern in g , G reat B rita in , 1 9 0 5 ___________________________________________ 1 6 8 - 1 7 1
W ool, g o a t h air, cam el hair, etc., im p o rts of, in to th e U n ited S ta te s, 1 9 1 0 to 1 9 1 5 104
W ool, h air, a n d b r istle s in d u stry , p r o te c tiv e le g is la tio n a s to, E u ro p e--------- #
--- 1 2 7 - 1 3 0
W ool in d u str y , a n th ra x , c a se s in , rep orted by B ra d fo rd (E n g la n d ) an d D is tr ic t
A n th ra x I n v e stig a tio n B oard , 1 9 0 6 to 1 9 1 4 ------------------------------------------121
W orkm en’s c o m p en sa tio n a ct, B ritish , ca ses o f a n th r a x com p en sated under, 1 9 0 8
to 1 9 1 4 _________________________________________________________________,------ -------133
W orkm en’s co m p en sa tio n la w , cla im s filed under on a c co u n t o f a n th r a x , M assac h u se tts, th re e y ea rs en d in g Ju n e 3 0 , 1 9 1 5 ---------------------------------------------109
W orkshops, sa n ita tio n of, recom m en dation s, N ew Y ork--------------------------------165
W orkshops, s a n ita tio n of, su g g ested r u les and reg u la tio n s, M a ssa c h u se tts
--------163
W orkshops, s a n ita tio n of, te x t o f E uropean reg u la tio n s as to (A p p en d ix B ) ------ 1 6 7 - 1 bJ







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O F TH IS P U B L IC A T IO N M A Y B E P R O C U R E D F R O M
T H E S U P E R IN T E N D E N T OF D O C U M E N T S
G O V E R N M E N T P R IN T IN G OFFICE
W A S H IN G T O N , D. C.
AT

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