View original document

The full text on this page is automatically extracted from the file linked above and may contain errors and inconsistencies.

U. S. DEPARTMENT OF LABOR

BUREAU OF LABOR STATISTICS
ROYAL MEEKER, Commissioner

BULLETIN OF THE UNITED STATES )
j WHOLE O I C
BUREAU OF LABOR STATISTICS) ’ * # (NUMBER £ J V )
INDUSTRIAL

ACCIDENTS

AND

HYGIENE

SERIES:

No .

19

EFFECT OF THE AIR H A M M E R
ON THE HANDS OF STONECUTTERS




JULY, 1918

WASHINGTON
GOVERNMENT PRINTING OFFICE
1918




CONTENTS.
Page.

Introduction.....................................................................................................................
5-7
Part I.—Preliminary investigation by the Bureau of Labor Statistics................. 9-51
Summary................................................................................................................... 9-16
Statements as to effect of use of air hammer:
Statements by em ployees.......................................................................
9
Statements by employers....................................................................... 10,11
Description of air hammer............................................................................. 11,12
Origin of the study......................................................................................... 12-16
Attitude of the employees...................................................................................... 16-33
Employees injured by the air hammer........................................................ 16-19
Statements of men injured............................................................................. 19-31
Employees not injured by the air hamiher................................................
31
Statements of men not injured......................................................................32, 33
Attitude of the employers...................................................................................... 33-51
Statements of employers................................................................................. 35-46
Report of investigation made in New Y ork................................................46-48
Reply of Journeymen Stone Cutters’ Association..................................... 48-51
Part I I .—Results of official investigations by physicians...................................... 53-123
Reports of physicians for the Bureau of Labor Statistics................................ 53-99
A study of spastic anemia in the hands of stonecutters, by Alice
Hamilton, M. D ........................................................................................... 53-66
Report of the physical findings in eight stonecutters from the limestone
region of Indiana, by Thor Rothstein, M. D .......................................... 67-96
Report on eight cases at Camp Shelby, Miss., by Maj. N. A. Cary,
Medical Corps................................................................................................ 97-99
Reports of physicians of the Public Health Service.................................... 100-123
Health hazards from the use of the air hammer in cutting Indiana lime­
stone, by J. P. Leake, passed assistant surgeon, United Slates
Public Health Service............................................................................. 100-113
Report to Surg. Gen. Blue on the supposed physical effects of the
pneumatic hammer on the workers in Indiana limestone, by David
L. Edsall, M. D ........................................................................................ 114-123
Part II I .— Statements of physicians reporting on behalf of the employees and
the employers...........................................................................................................125-144
Effects of use of air hammer on hands of Indiana oolitic-stone cutters, by
C. E. Cottingham, M. D .................................................................................. 125-133
Investigation into the effects of the pneumatic hammer upon the physical
and mental health of operators, by Francis M. Barnes, jr., M. D ..........133-138
Effect of pneumatic tools on marble workers, by Thomas H. Hack, M. D 138,139
A study of the effects of the pneumatic hammer upon workers in the marble
industry, by Arthur P. Herring, M. D ........................................................ 139-144
Appendix A .—Effect of air hammer on hands of granite cutters...................... 144-147
Appendix B .—Minutes of Bedford local of Journeymen Stone Cutters’ Asso­
ciation of North America........................................................................................
147
3







BULLETIN OF THE

U. S. BUREAU OF LABOR STATISTICS.
WHOLE NO. 236.

WASHINGTON.

JULY, 1918

EFFECT OF THE AIR HAMMER ON THE HANDS OF
STONECUTTERS.
INTRODUCTION.
This bulletin contains reports of studies as to the effects of the use
of the pneumatic chisel upon stonecutters, made by the United
States Bureau of Labor Statistics and the United States Public
Health Service, together with statements by physicians employed by
the workmen and the employers. The Bureau o f Labor Statistics
undertook this study by reason of the statements made by the presi­
dent of the Journeymen Stone Cutters’ Association of North America
and at the request of the American Association for Labor Legisla­
tion.
At first this inquiry was limited to the stonecutters of the lime­
stone belt of Indiana, as it was alleged that they are the only users of
pneumatic tools who suffer serious effects from such use. Two agents
of the bureau were sent to the Indiana limestone belt and secured
statements from both employers and employees as to the effects of the
air hammer on those using it. The bureau also secured from Dr. C. E.
Cottingham, who was employed by the Journeymen Stone Cutters’
Association^ a report of his observations upon seven men. The state­
ments o f the men and of the employers w ere so at variance that I
T
was unwilling to publish these statements without further investiga­
tion. Dr. Cottingham’s findings were especially disturbing and, if
corroborated by further study, would have made it necessary at least
to control the use of the air hammer in the soft stone industry by
legislation if not to abolish its use altogether.
Accordingly, I sent Alice Hamilton,, M. D., to Indiana to make
physical and medical examinations of the men who were said to be
suffering nervous and other disorders from using the air hammer.
Dr. Hamilton first visited Bedford and Bloomington, Ind., in April,
1917, examined some of the men, and made a first report. She rec­
ommended that she be permitted to make a second visit during the
cold weather when the hands of the stonecutters show most plainly
the disturbance of the circulation of the blood and the sensitiveness




'6

INTRODUCTION.

of the nerves. She therefore made a second visit in January and
February, 1918. In the meantime my attention was called to the
granite cutters of Quincy, Mass., and Barre, Vt., and to the marble
cutters o f Proctor, Yt., Long Island City, N. Y .? and Baltimore, Md.
The employers stated that the men working on granite and marble
suffered none o f the ill effects from using pneumatic tools that were
alleged by the cutters of the soft limestones. The granite cutters, on
the other hand, stated very positively that they did suffer from
“ dead fingers.” Accordingly, I instructed Dr. Hamilton to visit the
granite and marble centers to ascertain what the conditions are and
to include these trades in her final report.
Some letters were received by me from employers manufacturing
sandstone in Ohio and Missouri^ stating that their industry would
be seriously injured if the use of the air hammer were abolished by
law. Further inquiry disclosed that the workmen using the air ham­
mer in working sandstone were little affected thereby because the
tool was seldom used and then for only short periods.
Dr. Hamilton’s final report will be found on pages 53 to 66 below.
During her second visit to Indiana, Dr. Hamilton arranged to
have eight stonecutters go to Chicago for observation and tests of
sensation to heat, cold, touch, and pain. These tests were made by
Dr. Thor Rothstein, professor o f nervous and mental diseases of
Rush Medical College in the Presbyterian Hospital in Chicago. Dr.
Rothstein’s thorough and careful study extending over several weeks
throws much new light on the subject. Because of the long period
Iduring which Dr. Rothstein kept the men under observation and the
thoroughness o f the tests he applied, his report is especially valuable
and his findings o f fact will be accepted as authoritative.
Having learned that several soldiers stationed at Camp Shelby,
Miss., were stonecutters from the Bedford, Ind., district, and that they
were said to suffer from “ dead fingers,” I communicated with the
War Department, and in due course received a report from Maj.
N. A. Cary, o f the Army Medical Corps, on the physical condition
o f eight former stonecutters stationed at that camp. Maj. Cary’s
report will be found on pages 97 to 99.
In January, 1918, the Public Health Service made an investiga­
tion of the health hazards to stonecutters in the Indiana limestone
belt entirely independent of the Bureau of Labor Statistics studies.
The report made by J. P. Leake, passed assistant surgeon, and David
L. Edsall, M. D., are included in this bulletin by courtesy o f the
Public Health Service.
It is to be noted that the findings o f all the physicians employed
by the Bureau of Labor Statistics, the Public Health Service, and the




INTRODUCTION.

7

United States Army are in almost perfect agreement as to the nature
and extent of the disability suffered by the users of the air hammer.
The disorder is disagreeable and troublesome in cold weather, but is
not dangerous, and it does not seriously discommode the worker from
pursuing his calling. It may, however, prevent the stonecutter from
taking up an occupation requiring some delicacy of the sense of
touch or accuracy in the use of his fingers.
It is very desirable and entirely feasible to make changes in the
design of the air hammer and the cutting tools used so that the
workman may continue to use air power in cutting stone without
suffering any of the bad effects that usually result from working with
the type of air hammer now used. The suggested improvements in
the design of the pneumatic chisel would be good economy, for the
efficiency of the stone-cutter is considerably impaired by “ dead fin­
gers.” What is more important, the elimination of a painful occu­
pational disease would make for more contented workmen. A dispro­
portionate amount of time and talent has been expended upon the
study of 4 dead fingers,” a relatively harmless occupational disease.
4
It is to be hoped that one incidental result from these investiga­
tions will be the centering of public attention upon the most deadly
hazard in the stoneworking occupations—namely, tuberculosis.
Part I I I of the bulletin is taken up with the reports of the physi­
cian empjoyed by the Journeymen Stone Cutters’ Association and
three physicians reporting on behalf of the employers of Bedford,
Ind., Proctor, Vt., and Baltimore, Md.




R o yal M eeker,

United States Commissioner of Labor Statistics.




PART I — PRELIMINARY INVESTIGATION BY THE BUREAU OF LABOR
STATISTICS.
SUMMARY.
STATEMENTS AS TO EFFECT OF USE OF AIR HAMMER.
STATEMENTS BY EMPLOYEES.

The employees’ testimony is, for the most part, confined to de­
scribing the various detrimental effects of the air hammer upon their
health.
Employees say that a number of ills—numbness in one or both
hands or arms, loss of sleep, nervousness^ limbs “ going to sleep,”
headache, pain in various parts of the body, heart trouble, and
tuberculosis—are produced by the constant use o f the hammer for
any considerable period. They admit that sometime? the condition
is improved somewhat by the cutter’s stopping work for a time or
taking up some other occupation, but say that in many cases work
with the machine unfits the stonecutter for other employment because
it leaves the hands stiff, cramped, and numb. The workmen assert
that the employers insist on the use of the device and usually do not
allow its alternation with the mallet and chisel, that they refuse thq>
men a hearing on the evils resulting from work with the machine,
and threaten a lockout if the use of the hammer is not continued.
The men say that no ill effects were felt from the work of stonecutting until the air hammer came into use, and that upon return to
the hand method the general health often improves. Some stone­
cutters say that they prefer the pneumatic tool, but think its use
should be regulated and occasional use of hand tools allowed.
According to officials of the Journeymen Stone Cutters1Association,
to which most of the men belong, the effects of the use of the hammer
are worse in working with soft materials, like limestone, than with
hard substances, like iron and marble. They state that in Germany
the results of work with the air hammer are recognized as so dele­
terious that the device has been “ legislated ou t” o f the country.1
1 Thorough search by investigators of the Bureau of Labor Statistics failed to disclose
any legislation like that beie mentioned.




10

PRELIMINARY INVESTIGATION BY THE BUREAU.
STATEMENTS BY EMPLOYERS.

The employers’ opposition to the abolition of the air hammer is
based on the grounds enumerated below:
The employers declare that no case is known of permanent dis­
ability, paralysis, or insanity traceable to the use of the air ham­
mer. They admit that continued employment of the hammer does
apparently disturb the circulation of the blood and cause numbness,
particularly in the left hand, but claim that this condition lias also
been caused by the continued use of the mallet and chisel and can
not be attributed to the new contrivance. Employers say that if
the use of the hammer itself were harmful to the operator, the right
hand, which .holds the hammer, would be affected instead of the left,
which holds the tool, as is usually the case.
According to them, any harmful effects on the health of the cutter
are due to the abuse of the air hammer. They say that the pointing
and roughing should be done with the hand tools, but that because
more energy is required by the hand method, the cutter continues to
use the pneumatic hammer. Regulation of the weight of the blow
delivered, by plafing the finger or thumb over the exhaust, is re­
garded by the employers as a misuse of the machine, as there is a
stopcock on the pipe near the hammer for this purpose. The em­
ploying firms ^ssert that the hammer, properly used^ blows the dust
away from the workman, that it is really a help, and that the men
prefer using it to the old way. The fact that the tool is cold, which
is charged as one of the causes of the numbness complained of, is
admitted, but they state that the experiment of heating the air is to
be tried, and that any €>ther remedy for the fault will be welcomed.
Employers point out that if the complaints of the workmen against
the hammer are well founded, it is strange that no opposition has
been manifested among the structural-iron workers anct others who
use similar hammers, and draw the conclusion that the object of the
complaint is to make the work appear difficult and hazardous and so
to force an increase in wages. They draw attention to the fact that
general conditions in the trade are good, and that all establishments
are “ practically inclosed,” in contrast to conditions prevailing in
structural-iron work, in which the employee is exposed to all kinds
of weather.
The firms contend that the opposition shown is due to the reluc­
tance o f the workman to use a new method and to the fear o f labor—•
an ungrounded fear in this case—of. fewer positions as a result o f the
introduction o f labor-saving machinery. They maintain that under
present conditions the hammer is necessary to the trade, because by
its use stone is produced more cheaply and therefore can be sold
more cheaply than by the hand method; and the industry is thereby




SUM M ARY.

11

enabled to hold its own in the competition with artificial stone and
terra, cotta. They assent, finally, that the “ reform,” if there is to be
any, must come from the employees, as the employers are helpless in
the matter.
DESCRIPTION OF AIK HAMMER.

The air hammer, about which complaint is made, is used in con­
nection with the cutting and preparation ©f stone and: is similar to
the one employed in riveting in structural-iron work, shipbuilding,
etc., except that it is adapted to stonecufctmg tools. In structuraliron work the tool is not held in the hand but is inserted in the ham­
mer, both hands holding the hammer. It is held against the hot
•rivet for only a fraction of a minute at a time, the hand being
released while the hammer is being shifted or while the workman is
waiting for another rivet to be inserted. In stoneeutting work the
use of the hammer is nearly continuous and the tool must be held in
the left hand and- carefully guided by the pressure of the fingers.
The structural-iron riveters work in pairs and spell each other, so
that, counting the pauses,, no one man is actually using the hammer
more than three out of the eight hours of the day. Moreover the
hammer used is much heavier and part of the vibration is taken up
by the weight. The piston is long and does not deliver many strokes
a second—only about 24 or 25—while the stonecutters’ hammer has
a short piston and is said to deliver from 3,000 to 3,400 strokes a
minute, with a pressure o f 80 to 90 pounds. There is therefore little
similarity between the two kinds of work even i f a pneumatic ham­
mer is Used in each. The air for the hammer is heated in a few of the
Bedford mills in order to preven tch ok in g by little particles of ice
which form in the pipe leading to the hammer, but tile air which
issues from the exhaust is always cold in spite of this heating.
In the operation of the device, the tool which fits into the hammer
is held and guided by the left hand, while the hammer is held in the
right hand, the thumb or index finger sometimes controlling the
exhaust.,
method is said to be contrary to good usage, though
it is quite common. A valve in the pipe below tlie hammer is sup­
posed to be the proper controlling mechanism. There are various
sizes of air hammers in use in the different branches o f the trade.
In limestone cutting those most commonly employed are the f-inch
and 1 inch sizes; However,, in some mills they have in addition the
f-inch, the -J-inch, and the l|-mch hammer. The 1-inch hammer,
which is recommended by the manufacturer when only one machine
is installed, has a stroke o f about 3,000 blows to the minute under a
pressure o f 80 to 90 pounds.




12

PRELIMINARY INVESTIGATION BY THE BUREAU.

Several kinds of tools are used in these hammers. The principal
ones are the ^-inch chisel, the 1-inch tooth chisel, the 2^-inch tooth
chisel, the splitter, and droves of various sizes. The tools most
frequently used in the hammer for pointing and knocking off the
rough are the splitter and the “ go-devil,” a two-tooth chisel. The
air hammer and the tools used in connection with it are furnished
by the employer. In marble work |-inch, f-inch, and f-inch ham­
mers are chiefly used. Granite cutters have, in addition to the
various sizes of air hammers, two other pneumatic tools, the surfacer and the “ bull-set” or “ four-point.” Both are used in pre­
paring the surface of the granite and both differ from the air ham­
mer in that they are held perpendicularly with both hands grasping
the handle—the tool is short and can not be held in the left hand.
They therefore resemble the riveters’ hammer and not the one that is
the subject of the present study.
There are certain hand tools still in use, such as the hand hammer,
the pitching tool, the hammer points, mallet, and mallet-head points.
These tools are furnished by the stonecutter and are intended to pitch
the rough stone to the marked line and point off tke rough.
ORIGIN OF THE STUDY.

As stated above, the attention of the bureau was drawn to a dis­
pute between the employers and the employees in the Indiana oolitic
limestone belt through a speech delivered on December 28, 1916, at
Columbus, Ohio, before the American Association for Labor Legis­
lation, by Mr. Sam Griggs, president o f the Journeymen Stone
Cutters’ Association o f North America. This address contained
specific charges as to the injurious effects of the air hammer on the
health of the stonecutters.
Mr. Griggs’s speech was as follows:
I represent’ a labor organization, the stonecutters’ union, and I am
very sorry that there are not more of us here this afternoon. O f
course we are affiliated with the American Federation of Labor, and
in a measure the federation is opposed to compulsory insurance. We
came here to-day to investigate, to learn something, and probably to
do away with t’he opposition we have had toward compulsory in­
surance.
The stonecutter is a migratory sort of fellow, and I don’t know
how he will fit into your scheme of insurance. He may be working
to-day for one contractor and to-morrow he may be out o f a job, and
several days afterwards he may be four or five hundred miles away
looking for another job under another contractor. It is, as I under­
stand it, not necessary for him, under the proposed bill, to go through
a physical examination. Physical examination would be especially
serious in our line of business if required. We are subject, as an
occupational disease, to tuberculosis. Most of our men are more or
less afflicted with it through the nature of their calling. They work
on sandstone, and the small particles of sand underneath the chisel
rise, are inhaled, and settle on the lungs and tuberculosis follows.




SUMM ARY.

13

There has been no attempt upon the part o f the employers to help
us in any way to take care of the men when they become afflicted
with tuberculosis. The men are absolutely powerless to help them­
selves. For that reason, too, I came down here to learn about your
plan, to see if it would help us in any way to take care of them.
I
have another little thing here that I want to bring to your at­
tention. I heard one of the employers this morning say that they
should not be hurried in regard to health insurance, that they don’t
want-to have it thrust upon them too fast. Anything that the em­
ployers conceive, however, they don’t hesitate a moment to thrust
upon the workingmen. They are now pushing this efficiency move­
ment you have heard so much about from Mr. Taylor and others.
Here is a tool in our business they call an efficient one. [Shows
tool.] It was gotten up by an efficiency expert. It is a pneumatic
tool, superseding the old-fashioned mallet and chisel. On this end
is a heavy rubber hose, and they run it with 80 to 100 pounds’ pres­
sure. This tool has an inch stroke and it strikes 3,400 blows every
minute. The incessant vibration soon starts to paralyze the hands
of a man who cuts stone with it. First it affects the left hand till
it reaches the elbow, then it starts on the other hand. When a man
gets up in the morning his fingers are bent double and he has to pull
them out forcibly and go through a violent exercise until he gets
some circulation into them. We had a case where the disease at­
tacked the spinal cord and made a man violently insane. He was
a perfect specimen of manhood, 37 years old, and he laughed when
the doctor told him that if he did not quit using this efficiency expert’s
device he would go insane. But he went insane, as the doctor pre­
dicted, and a short while later he died.
This tool is an inhuman thing. We have tried every way possible
to have the employers investigate the results of using it. Recently
we have had a controversy with the employers over the use of this
tool—some of them are bigger than this—find they told us that when
the local agreement in our district expires on the 12th day o f next
month, if we refuse to use this tool, no matter what the result may
be to our physical well-being, they will lock us out under the terms
o f the agreement with our international union.
I
am glad that Dr. Andrews invited us to come here to-day, and
we have been glad to bring this device with us and try to show you
what effect it has on the men.
In Germany, under health insurance, this hammer was four or five
years ago legislated out o f the country entirely. One reason was
because it affected a man’s efficiency. As experts they did away
with it entirely and would not allow it to be used. When the time
comes they will do away with it in this country, not for military
purposes, but for health purposes.
As a result of this speech, the American Association for Labor
Legislation, at its annual business meeting on December 29, 1916,
passed the resolution given below:
Whereas representatives o f the stonecutters’ organization have presented to this
meeting o f the association evidence o f the injurious occupational effects o f
dust and o f the pneumatic tools o f their industry, resulting in tuberculosis
and paralysis.




14

PRELIMINARY INVESTIGATION BY THE BUREAU.

R esolved, That the United States Bureau o f Labor Statistics be urgectly
requested by this association to make a thorough investigation o f these condi­
tions and their effects on the workers and to report upon the same at as early
a date as possible within the ensuing year.

Request made o f the Journeymen Stone Cutters’ Association, by
Dr. Hamilton, for information in regard to the disease mentioned
as being contracted by stonecutters, brought a reply from the general
secretary o f the union which is of interest here in that it sum­
marizes the attitude of that association on the air-hammer question.
The letter is as follow s:
I n d i a n a p o l i s , I n d ., April 18, 1917.
Deab Dr. H a m i l t o n : I am ju st in receipt o f your valued favor o f the
16th instant and I am pleased to learn that Dr. Joseph Miller, o f Chicago, has
written you concerning the peculiar disease suffered by our members who use
the pneumatic, or air, hammer in the cutting o f stone, and that you are suffi­
ciently interested in the matter to consider making an investigation.
During the last 10 years, the pneumatic, or air, hammer has been introduced
into our trade as an efficiency tool* supplanting the mallet and hammer as
heretofore used by the stonecutter, and to-day its use is universal in what is
known as the Indiana oolitic stone belt, comprising the cities o f Stinesville,
EllettsvUle, Bloomington, and Bedford, Ind., and while many o f our members
refuse to use this tool owing to its detrimental effects upon their physical w ell­
being, the employers in the Indiana belt deny employment to such men as will
use only the lools o f their trade, the mallet and hand hammer.
This tool has been gradually introduced into the trade, and it is o f very
recent years that mechanics have been compelled to use it for aU stonecutting, or throughout the entire working-day of eight hours. Prior to its uni­
versal installation in the Indiana stone belt, the mechanic used the tool on light
w ork or for cleaning-up purposes, which afforded him an opportunity to escape
in a measure its inhuman effects, as he could rest his nerves and muscles by
using the mallet or hand hammer in the interim. However, the employers
seemed to have no regard whatever for humanitarian restrictions on the use
o f this tool, and eventually forced all employees to use it constantly throughout
the entire eight-hour day. I f the employee was found resting, or in a measure
protecting himself by laying down the air hammer and using his mallet or hand
hammer, he invariably was paid off and his services dispensed with, and while
he was not advised that his refusal to use the air hammer continually was the
cause o f his discharge the evidence was too plain to deny i t
During the past five years hundreds o f complaints have reached this office
o f the detrimental effects o f the continued use o f this tool. Many o f our local
unions throughout the country have refused to use the tools at all, and as a
result are not at this time using them. In these cities the stand taken by our
local unions was possible, owing to the fact that the air hammers had not pre­
viously been universally installed.
The officers o f this association have on several occasions, in meeting with the
Cut Stone Contractors* Association, o f which most all operators in the Indiana
stone belt are members, submitted this question o f the air hammer and its
ruinous physical effects and requested that something be done to remedy the
evil.
The employers have treated this subject very lightly— I might say almost
w ith contempt? in fact, during recent negotiations for a new wrage scale in
the Indiana belt they flatly refused to meet with the men if they insisted on
My




SUMM ARY,

15

subm itting this air-hammer question and discussing the same. This in itself
would convince one that they proposed to use this tool in their shops irrespec­
tive o f whether it ruined the health o f their employees, treating their employees
in the same manner as they would a horse or a mule, possibly with the satis­
faction to themselves o f being able to get another stonecutter when they had
worked one into physical ruin.
In order that we might interest the general public in this inhuman tool,
Mr. Griggs, president o f the association, and m yself attended the convention
o f the American Association for Labor Legislation held in Columbus, Ohio,
December 28, and laid this question before them. The result was that the
American Association for Labor Legislation passed a resolution calling upon the
Department o f Labor to make an investigation o f this tool and its effects upon
men who used it in the Indiana stone belt. The United States Department o f
Labor did make such an investigation, Special Agents H arry L. Smith and
Paul II. Moneure spending some three weeks in Indiana stone fields, ques­
tioning the men who had been using this tool. These gentlemen were in a
manner handicapped by the fact that the stonecutters in the Indiana field w ere
a little reticent about making statements, fearing, as it was quite natural for
them to do, that they would later be objects o f discrimination, if not blacklisted,
by the employers. At any rate, Messrs. Smith and Moncure collected consider­
able data, and I learned recently upon the occasion o f a visit to the offices o f
tlie Department o f Labor at Washington that their report had been filed with
the chief clerk.
W e agreed with Messrs. Smith and Moncure, wrhen they called at this office,
to submit some o f our members who had been using this tool to a specialist
for examination and a complete diagnosis o f their physical condition. Accord­
ingly we took the matter up with a surgeon here in Indianapolis, and he re­
ferred us to a nerve specialist, a Dr. Cottingham. W e submitted some seven
men to him for examination, ranging in age from 22 years to nearly 60. Four
o f these men he examined daily for a period o f four days. He is to furnish us
with a complete stenographic report on the results o f these examinations, but
when calling on him a few days ago he advised us that owing to sickness and
a press of business he had been unable to complete the report, but that we
should have it in a few days.
This report o f Dr. Cottingham will be forw arded to the United States Depart­
ment o f Labor to be used in conjunction with the report o f the investigation
made by the Department. I am sure I do not know the extent o f this report
or its probable findings, but if you or Dr. Miller are to make a study o f this
subject, I would be pleased to furnish you with a copy o f the same.
Now, the Indiana stone belt, as stated above, comprises the cities o f Stinesville, Ellettsville, Bloomington, and Bedford. Stinesville is about 45 miles
from Indianapolis, and the fou r cities are situated on the Monon Route.
Stinesville is reached in about two hours from Indianapolis, then Ellettsville is
5 miles farther south, while Bloomington is about 20 miles from Bedford. I
should judge that an investigation could be made in the three cities in a week.
W e have about 200 men in Bedford, about 65 in Bloomington, 15 to 20 in
Ellettsville, and but 2 or 3 at this time in Stinesville. It wT
ould be my judg­
ment, should you decide to make an examination in conjunction with Dr. Miller,
that we could make arrangements for you to get a number o f men together at
one time.
I f there is anything further on which I could advise you, I would be only too
pleased to do so. This tool has proved a most inhuman one, and we are only
too pleased to interest and assist anyone who can bring it before the public. I
am sure that, knowing its effects upon the members as we do, the time is not




16

PRELIMINARY INVESTIGATION BY THE BUREAU.

fa r distant when our members will absolutely refuse to use it, which without
doubt w ill bring on a bitter industrial struggle, as the employers seem deter­
mined to use it regardless o f its effects.
I might add also that from time immemorial the stonecutter has been a victim
o f tuberculosis. Our death records show this disease to have taken a verylarge percentage o f our members. The air hammer, instead o f relieving this,
adds to the mechanic’s susceptibility o f contracting tuberculosis, inasmuch as
with the mallet the blows are intermittent, thus giving the dust a chance to
blow away, and the cutter therefore escapes a great portion o f it. W ith the air
hammer and the constant vibration o f a stroke from 3,000 to 3,400 revolutions
per minute, a constant stream o f fine dust is thrown in the operator’s face as
he bends over his work, and he has no chance o f escaping even a portion o f it.
The inhalation o f this dust invariably brings on tuberculosis.
Assuring you that we are pleased to have you take this matter up and that
we will be only too pleased to assist you in any way possible, I am,
Yours very truly,
W

alter

W . D rayer,

General Secretary.

The Bureau of Labor Statistics sent into the limestone belt of
Indiana two agents who conducted an investigation during the
months of January and February, 1917. Statements as to the effect,
if any, of work with the pneumatic hammer were obtained from 97
employees; o f these, 68 reported that they had been injured and 29
•that they had not. This, however, can not be taken as indicating in
any way the general proportion of cutters injured, since it was impos­
sible to interview anywhere near the total number of stonecutters
in the district. Testimony was also received from 18 firms of the
district as well as from two associations of which most o f these firms
are members. A ll of this evidence ig here presented in full.

ATTITUDE OF THE EMPLOYEES.
EMPLOYEES INJURED BY THE AIR HAMMER.*

O f the 68 limestone cutters who report being injured by the use
of the air hammer, 46 work in Bedford, 16 in Bloomington, and 5 in
Ellettsville, Ind., and 1 in Rockford, 111. The general secretary o f
the union reports that there are approximately 200 union stonecutters
at work in Bedford, 65 in Bloomington, 15 to 20 in Ellettsville, and
2 or 3 in Stinesville. A ll of the 29 men who state they have noticed
no ill effects work in Bedford.
The ages reported by the 68 workmen range from 21 to 62 years,
the average age being 34.5 years. The following tabular statement
shows their distribution by age groups;




ATTITUDE OF INJURED EMPLOYEES.
T able 1 .— N U M B E R

17

A N D P E R C E N T IN E A C H A G E G R O U P O F L IM E S T O N E C U T T E R S
IN J U R E D B Y T H E U SE O F T H E A IR H A M M E R .
Number.

Age group.

Per cent.

21 to 25 years...............................................
26 to 30 years...............................................
31 to 35 years...............................................
36 to 40 years...............................................
41 to 45 years...............................................
46 to 50 years...............................................
51 years and over.......................................

12
15
11
15
7
3
5

17.6
22.1
16.2
22.1
10.3
4.4
7.4

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

68

100.0

As this table shows, more than three-fourths (78 per cent) of the
68 workmen are 40 years of age or less. Practically the same pro­
portions (39.7 and 38.3 per cent, respectively) are in the age groups
21 to 30 and 31 to 40 years.
With the exception of one man, who at the time of making his
statement had used the pneumatic hammer only 2 weeks, the length
of experience with the machine reported ranges from 1J to 16 years,
the average being 5.8 years, as compared with 9.2 years, the average
among the employees who report that they have not been affected
injuriously.
In the table below are shown the number and per cent of em­
ployees injured by the hammer, classified by length of experience;
for purposes of comparison the same information is given for em­
ployees who have not been harmed.
T a b l e 2 . — N U M B E R A N D P E R C E N T OF E M P L O Y E E S H A R M E D A N D E M P L O Y E E S U N ­

HARM ED B Y THE
W IT H HAM M ER.

U SE

OF T H E

A IR

HAM M ER,

BY

LENGTH

Employees harmed by
air hammer.

OF

E X P E R IE N C E

Employees unharmed
by air hammer.

Length of experience with air hammer.
Number.

Per cent.

Number.

Per cent.

1 and under 2J years....................................................................
2^ and under 5 years....................................................................
5 and under 7J years....................................................................
7 Land under 10 years..................................................................
,
if) and under 12\ years................................................................
r.i years and over................................................... ..

5.
18
31
6
5
2

7.5
26.9
46.3
9.0
7.5
3.0

1
4
10
2
3
8

3.6
14.3
35.7
7.1
10.7
28.6

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

i 67

100.0

2 28

100.0

1 Not including 1 who had used the hammer only 2 weeks.
2 Not including 1 who did not report length of experience with the hammer.

Almost twice as many employees injured as those uninjured
(34.4 against 17.9 per cent) have used the hammer less than five
years. Four-fifths (80.7 per cent) of those injured, as compared with
n little over one-half (53.6 per cent) of those uninjtired, have been
working with the pneumatic hammer less than seven and one-half
18476°— 18— Bull. 236------ 2




18

PRELIMINARY INVESTIGATION BY THE BUREAU.

years. On the other hand, a very much greater percentage (39.3 as
against 10.5 per cent) of workmen have employed the hammer 10
years or more among those not harmed by this device than among
those affected injuriously. This may be an indication that the dele­
terious results, if any, appear comparatively early in the working
experience, or that after a time the workman becomes inured to the
constant vibration and no longer experiences any discomfort;1 but
the numbers reporting are too small to be conclusive.
The workmen complain of being injured in a number of ways.
Sixty-five of the 68 employees complain of injury to their hands, 34
reporting injury to both hands, 21 to the left hand, 2 to the right,
and 8 to u the hand,” not specifying which one. The following table
shows the injuries reported, in addition to those affecting the hand:
T

able

3.—NUMBER OF INJURIES REPORTED AFFECTING EACH SPECIFIED PART QF
BODY.

{The groups in this table are not mutually exclusive, since the same workman may have
reported injuries to several parts.]

Part of body affected.

N eck...................................................................
Chest..................................................................
Right lu n g ......................................................
Heart..................................................................
Nerves...............................................................
B ack...................................................................
Left side............................................................
Left eye.............................................................
Both eyes..........................................................

Number
of injuries
reported.
1
2
1
5
13
1
4
1
2

Part of body affected.

Left shoulder.................................................
Right shoulder..............................................
Both shoulders..............................................
Left arm..........................................................
Right arm .......................................................
Both arms......................................................
Arm not specified........................................
Both legs.........................................................

Number
of injuries
reported.

2
2
2
16
2
5
2
2

One man says the effects are so severe that he can work at stonecutting only two or three months at a time. One cutter says his gen­
eral condition improves when he stops work for a while; three have
improved since going back to the hand method; while two others de­
clare that the fingers of the left hand are numb and turn white in
cold weather whether or not they are using the hammer.
Statements made by the men would seem to indicate that, whether
or not the employers consider work with the pneumatic hammer
harmful, the insurance companies do. One stonecutter’s rate has
been doubled, another was refused insurance, except at a prohibitive
rate, by three companies, and a third was refused insurance al­
together.
O f those who report on the point at all, seven say that they have
not consulted a physician, and only nine that they have done so.
The reason given as to why there were so few of the latter was that
other men who had sought the advice of a doctor had merely been
1 The experience of 3 workman, who has been using the hammer for 11 years and who
suffered extreme numbness in his hands during the first 6 years, which has gradually
improved till now only the tips of the fingers are numb, would seem to bear this out.




ATTITUDE OF INJURED EMPLOYEES.

19

told to stop using the hammer. This fact being generally known, the
employees did not want to incur the expense of a visit to a physician.
The statements made by the employees who report that the use of
the hammer has injured them are given below:
STATEMENTS OF MEN INJURED.
EMPLOYEE NO. 1, AGE 3 7 .

I have been using the air hammer about six years.
The fingers o f my left hand are numb and in cold weather they get white.
My left arm pains as fa r up as the shoulder; the whole left side is painful—■
has shooting pains— and I can not sleep for* hours on account o f the pain. The
left leg is also affected the same as the arm. Have been troubled with these
pains in my arms and legs for over a year. The use o f the air hammer has
also affected my heart. I can not hear in my right ear. I have never been
to see a doctor.
EMPLOYEE NO. 2 , AGE 2 4 .

I have used the pneumatic hammer for about six years.
The little finger and the one next to it are riumb in cold weather on ly; the
numbness extends up ti the palm o f the hand. I have no objection to using the
air hammer, and would rather use it than the mallet and chisels. I am nervous
at times, but think this comes from using coffee.
EMPLOYEE NO. 3, AGE 3 9 .

I have used the air hammer about five years.
I have dead fingers in both hands; mostly in the le ft; I never have seen a
physician on account o f it. The hammer has had no injurious effect except
on my fingers.
EM PLOYEE

NO.

4,

A GE 2 7 .

I have been using the air hammer off and on for the past seven years.
The index finger o f my right hand is affected in cold weather only, and I
feel a pain constantly in i t ; gloves will not keep it warm. My left side near
my heart is also affected. I judge this comes directly from using the hammer.
I was sick in December, 1915, and asked the doctor if my sickness was due to
working with the air hammer. He replied, “ I can hardly tell, but I think it
was.” W ithin the last two or three years I have had severe headaches, one
about every two weeks, lasting two and three days at a time, but occurring
more frequently in the summer than in the wmter. I think these are brought on
by the use o f this tool. It wrecks a man’s nervous system. I used to play base­
ball, but since using the air hammer I can not throw, as I am shoulder bound.
I called on the manager o f the Public Savings Insurance Co., o f Indianapolis,
and he suggested to me that I take out insurance on my life. He asked my age
and occupation, and when he found I was a stonecutter he asked if I worked
with the pneumatic air hammer. I said, “ Yes.” He then closed the book and
said, “ Nothing doing.”
EMPLOYEE NO. 5, AGE 3 8 .

I have been using the air hammer about five years.
Four fingers o f my left hand up to the knuckles and the first finger o f my
right are numb. The cause o f the finger on the right hand being numb is that




20

PRELIMINARY INVESTIGATION BY THE BUREAU.

1 regulate the exhaust with that finger. It takes me sometimes fully five
minutes or more to get the circulation back into my fingers by violent exercise.
[W hen this man made the above statement the left hand was like a dead
hand and had a peculiar look.]
EMPLOYEE NO. 0, AGE 4 7 .

My occupation is that o f driller. I drill all the lewis holes in the stones
for hoisting, using the Ingersoll air drill. I have been using this air drill about
four years.
It affects me in two different w ays: (1 ) It deadens the hand and stops the
circulation o f the blood, especially the fingers o f my left hand. (2 ) It makes
the muscles sore. I think that this is caused by the vibration o f the drill.
I made the statement [to the employer], in the office o f the mill, that I had a
dead hand from the effects o f the air drill. He replied that I did not have to
run a drill for him.
EMPLOYEE NO. 7, AGE 3 7 .

I have used the air hammer about four years.
My fingers get white and “ go dead ” in cold weather. I f I am working
steadily with the aft* hammer, my left arm goes to sleep and I can not sleep
on my left side. I have never seen any physician regarding this trouble. When
I am cleaning a big surface, my left hand, especially tjie palm, becomes very
sore from the ja r caused by the hammer and sharp pains shoot through it. I
sleep all right except when I have a strenuous day, then I become nervous and
can not sleep.
W e use about 80 pounds’ pressure on these hammers.
EMPLOYEE NO. 8, AGE 3 5 .

I have been using the air hammer about four years.
Both hands are dead. I can not sleep on my left side. I have not consulted
n physician, as I knew the rem edy: “ Stop using the hammer.”
I am chairman o f the Oolitic Belt Conference and have brought the subject
of the ill effects o f the air hammer before the Bedford Stone Club, composed
o f bosses. They owned up to me that there were ill effects from using the
hammer, but would not go into the matter, as they considered it a national
affair, and if the men did not use it they would lock the men out.
EMPLOYEE NO. 9, AGE 4 0 .

I have been using the air hammer, all told, about six years.
It numbs both o f my hands as fa r back as the palm. It also affects my left
arm and shoulder, and at times when I have rheumatism or have taken cold, it
affects my entire left side. I do not feel it on the right side except on my
hand and fingers. It makes me nervous and I lose a great deal o f sleep, and
jifter a hard day’s work it affects my heart. The use o f this hammer affects
the circulation o f the blood more in the winter than in the summer months.
The air used in the hammers is ice cold at all times. Dr. ---------- visited me
while I was at work in the yard. I handed him this air hammer, and he
remarked that it would cause paralysis for anyone to use it.
EMPLOYEE NO.

10,

AGE 3 7 .

I have been using the air hammer about five years.
It deadens my fingers. The finger next my little finger gets white first and
has no feeling in it at all. The hammer also affects my left arm so that I
can not sleep on that side. A fter using the hammer constantly I am unable to




ATTITUDE OF INJURED EMPLOYEES.

21

sleep at night. I have never been to see a physician to get any remedy for
it, but while on other business I have spoken to doctors about it and they said
it was on account o f the constant ja r o f the hammer. W e have to use the
hammer or stop work. I have complained only through the committee,
EMPLOYEE NO. 11, AGE 3 6 .

I have used the air hammer about four years.
It causes a numbness in the three fingers on the left hand, coloring them to
a whitish blue yellow. When the left arm is extended it is affected with sharp,
shooting pains. Use o f the hammer also produces restlessness at night, result­
ing in loss o f sleep. In the morning I spit up lumps o f stone dust which were
gathered during the preceding day. These have been noticed since I have used
the air hammer, which covers the period mentioned a b ove; nothing o f the kind
was ever observed when I worked with the chisel and mallet, a period covering
about 17 years. I consulted D r . ---------- , who stated he would not work at such
a trade on account of the injurious effects o f the air hammer.
EMPLOYEE NO. 12, AGE 4 1 .

I have used the air hammer about three years and four months.
It causes my hands to turn white and I have no feeling in the fingers o f both
hands or in my shoulders, especially when I work hard. I h^ive to sleep on
my back or stomach, as I can not sleep on either my right or left. side. The
hammer has also affected my hearing and I notice that when I have not been
working for about six weeks my hearing is improved. I have never seen a
physician regarding this trouble.
EMPLOYEE NO. 1 3 , AGE 3 6 .

I have used the air hammer three years.
I was compelled to use the pneumatic hammer in the plaje o f the mallet. It
numbed the nerves in the arms from the finger tips up into the body and,
according to physician, affected the nervous system o f the whole body, stopping
the circulation o f blood. The fingers o f my left hand are cold and stiff, mostly
in cold weather. I was compelled to stop work on account o f air hammer. I
was examined by a physician on or about the 5th day o f June, 1916, and ad­
vised to give up the use o f the air hammer.
EMPLOYEE NO. 1 4 , AGE 4 4 .

I have been using the air hammer about eight years.
On my left hand the thumb and fingers are derid; there is no circulation
except after violent exercise and rubbing. The index finger and thumb of my
right hand, up to the palm, are also affected the same way. I have watched
the development o f the action o f the air hammer on my hands. The constant
vibration o f the air hammer stops the flow o f blood through the fingers to the
tip ends, causing the veins o f the fingers to become sluggish and inactive, and
allowing the freezing temperature to keep the blood from circulation, so that
the fingers completely die. In order to bring back circulation it is necessary
to throw the arms across the shoulders for some time. The use o f the air
hammer also causes intense pains to shoot through the joints, arms, shoulders,
both limbs, hips, and spinal column to the seat o f the brain, causing a dull
and heavy feeling at the base o f the brain and restlessness or nervousness, and




22

PRELIMINARY INVESTIGATION BY THE BUREAU.

an unnatural sleeplessness. I have not used the air hammer for the past three
weeks and am now working by the old hand method. I am now getting back
the natural feeling to a great extent and feel much improved in general, but
I don’t think that I w ill ever get back to normal condition, as I was before
using the air hammer.
EMPLOYEE NO. 1 5 , AGE 3 3 .

I have been using the air hammer a little over three years.
The four fingers and thumb o f my left hand are dead and I have no feeling
in them, and this extends to my shoulder. I can not raise my left arm to my
shoulder without taking my right hand to help. My right hand is also partly
affected. In May, 1914, I could not sleep at nights. I had been steadily using
the air hammer for 21 months, nearly every working-day. I consulted Dr.
—;------- in regard to bad heart action and he replied that there were several
ways that the heart could be speeded up, as, for instance, lifting a heavy object
or taking a long run. I told him that I had done neither. H e then asked me
at what I was employed. I told him I was a stonecutter and was using the
pneumatic hammer. He then told me that was very likely the cause o f it.
He gave me some medicine to reduce the heart action and told me to keep
quiet fo r several days. The heart action was reduced by the quiet and the
medicine, but upon my returning to work it became as bad as ever again.
One day after working eight hours I went back again to the same doctor,
as my heart was bothering me the same as before. The doctor then made
another examination and found the action o f the heart above normal. H e also
found, at this time, that the nerves o f my left arm were sort o f fluttery or
quivery and advised that I try something else for a livelihood. I did not take
his advice, but returned to work. After a short while I consulted our fam ily
physician and, after an examination, he told me that the nerves were badly
shattered and were being deadened, and that heart action was above normal,
but that this was caused by the bad nerves. Dr. ---------- explained to me that
when the deadening o f the nerves reached the spinal column it would result
in paralysis. H is advice was to quit the business, and I did quit the business
at that time for five months, and I felt better and rested well at nights.
I then returned to the business and worked for three months, when I became
nervous again and could sleep but little. I then left the business again for a
little over seven months and went to farm ing and have returned to the business
only from two to three weeks at a time.
EMPLOYEE NO. 1 6 , AGE 3 5 .

I have been using pneumatic hammer about six years off and on and have
used it continuously about 18 months. I have been foreman o f a mill and have
not used it very much in the years previous to the last 18 months.
The first two fingers and the thumb o f my right hand are numb and in cold
weather become entirely numb, and I am forced to rub or swing them violently
in order to bring the circulation back to them. It makes no difference what
kind o f w ork I am doing these fingers and the thumb go dead in cold weather.
I think the vibration caused by the air hammer is the cause o f the noncircula­
tion o f the blood. The left arm from the elbow to the shoulder seems to be
bruised and gives me considerable pain and causes loss o f sleep at times. The
fingers and thumb o f my left hand are entirely numb up to about the center
o f the palm, and this is very painful sometimes.
Men are compelled to use the air hammers or there is no job. I f you persist
in using hand tools and mallet you can look for another job.




ATTITUDE OF INJURED EMPLOYEES.

23

EMPLOYEE NO. 1 7 , AGE 2 9 .

I have been using the air hammer about seven years.
'The four fingers o f my left hand get numb and my arm to my shoulder aches
most o f the time, both winter and summer. It also affects my sleep, and I
can not sleep on my left side at all. I have a pain in my chest. I think it is
caused by leaning forw ard with both hands while using the hammer. I have
to relax in order to get a full breath, but that does not stop the pain. Fre­
quently when I take a full breath my chest bones crack. My sleep is broken
at nights and I am nervous both day and night, b u t. especially at night. I
have consulted a physician in regard to a pain under my right shoulder blade.
The doctor said to stop using the air hammer.
I have been unable ^;o get life insurance. I was refused insurance, except
at a prohibitive rate, by the Prudential, o f Newark, N. J., the Metropolitan
Life, and the New York L ife on account o f using the air hammer.
[The only policy the Prudential Insurance Co. w ill write a stonecutter using
the pneumatic hammer is on the 20-year endowment plan at a “ hazardous ”
rate o f $46.98 per year, the highest rate given by the company. Stonecutters
not using pneumatic tools get a medium rate; those using them are rated as
“ hazardous ” and pay a difference o f $2.38 per thousand.]
EMPLOYEE NO. 1 8 , AGE 4 3 .

I have been using the air hammer about nine years.
The fou r fingers o f my left hand, up to the knuckles, are numb and I feel
a stinging in the fingers and arm. Sometimes when feeding the. furnace I feel
pains around my heart, and this especially when I stoop.
The Metropolitan L ife Insurance Co. has increased my premium from 10 to 20
cents per week.
EMPLOYEE NO. 1 9 , AGE 3 0 .

I have been using the pneumatic hammer about six years.
It causes the last three fingers o f my left hand to become numb, and there
is no circulation in these fingers up to the palm o f my hand in cold weather,
but it does not seem to bother me in the summer months. It causes considerable
pain. In the winter time this condition would prevent me from follow ing any
occupation where the use of my fingers would be required.
EMPLOYEE NO. 2 0 , AGE 3 6.

I have been using the pneumatic hammer off and on for about six years.
It stops circulation in the fingers and causes them to become numb. On days
when the work is heavy I feel it in my arms. It used to affect my sleep, but it
has not done so for some tim e ; I suppose I have become inured to it. At times
it causes considerable pain, and would prevent me from doing any outside work
where the use o f my fingers would be required.
EMPLOYEE NO

21,

AGE

29.

I have used the air hammer about five years. I am allowed to use hand
tools for roughing off (pointing with mallet or hamm er).
The use o f the air hammer affects me in the follow ing manner: It deadens
the three fingers o f my left hand— not the index finger— and the index finger
o f my right hand, as far back as the palm of the hand. This feeling bothers




24

PRELIMINARY INVESTIGATION BY THE BUREAU.

me only in cold weather and is particularly noticeable on ordinary frosty
mornings in the early fall. After a great deal o f cleaning up stone or tooling
w ith the hammer, both o f my arms ache and feel as if they were asleep, antf
sometimes in the night I have to get up and sling my arms in order to get
the circulation into them.
EMPLOYEE NO. 2 2 , AGE 2 4 .

I have been using the pneumatic hammer about fou r years.
The first two fingers o f my left hand are dead— that is, have no circulation—
and the hammer makes my left arm gore from the shoulder down. It affects
me mostly in the winter months.
#
EMPLOYEE NO. 2 3 , AGE 3 9 .

I have been using the air hammer for about eight years, in different parts
o f the country.
The thumb and fou r fingers o f my left hand, and the first three fingers o f my
right hand are affected, and on cold and frosty mornings I have to put them
in hat water in order to restore the circulation. W ork with the hammer also
gives me pains in my chest and has affected my left arm between the shoulder
and elbow. I do not feel natural on my left side at all. I have put my
affected fingers in water .so hot that my good fingers could not stand it. My
arms frequently go to sleep— and this is almost a nightly occurrence, several
times in a night— and I have to massage myself in order to bring the circula­
tion back. I am very nervous at all times, and being struck suddenly, even
slightly, causes me te jump. My left leg frequently goes to sleep and gets
cold three times as quick as my right, and on one occasion I lost feeling in it
entirely and sat in the bathtub and bathed it in hot water for three hours
before the circulation retu rn ed; and it has not become entirely right yet.
I am perfectly w illing to go before any unbiased physician and pass a
physical examination as to the effect o f the air hammer on me.
EMPLOYEE NO. 2 4 , AGE 3 9 .

I have been using the pneumatic hammer about three years off and on. I
have used it only about nine days since last September.
The fingers and thumbs o f both hands are numb, a u l the cold weather
affects th em ; they are very painful. It has affected my left a r m ; I have a dull
heavy pain in the back o f my neck at the base o f the brain.
EMPLOYEE NO. 2 5 , AGE 4 3.

I have been using the air hammer for about five years.
The fingers o f both hands are numb and in cold weather turn white. I can
not write or hold anything when my fingers are in this con d ition ; they are
perfectly useless. I also have a severe pain at times in my right elbow, espe­
cially when I use the hammer continuously.
EMPLOYEE NO. 2fi, AGE 2 3 .

I have been using the air hammer about tw o years.
The last two fingers o f my right hand get cold and numb in cold weather.
There is also an effect on my nerves and neck. The least racket or noise jars
me and causes me to start. The stiff neck is caused by using the hammer, and
is not caused by cold. My left hand is not affected at all.




ATTITUDE OF INJURED EMPLOYEES.

25

EMPLOYEE NO. 2 7 , AGE 3 0 .

I have used the air hammer about two years.
Whenever I get in the cold my fingers and thumbs get numb and there seems
to be no circu lation ; my left arm has shooting pains up to the shoulders. My
nerves are all shattered. They frequently keep me awake at night. Since
stopping work with the hammer and going back to the mallet I do not feel so
bad, and am getting over the nervousness.
EMPLOYEE NO. 2 8 , AGE 2 2 .

I have been using the pneumatic hammer close on to two years.
It has torn up my nerves, and the nerves have affected my heart. I consulted
a physician in August, 1915. He said that my nerves were all torn up and
that it had affected my heart and that I would have to give up using the air
hammer. The first three fingers on my left hand are numb and without feeling,
and this is especially so on cold, frosty mornings. I have been cutting stone
with the mallet since November 1, and my heart has not bornered me since.
EMPLOYEE NO. 2 9 , AGE 4 8.

I have been using the pneumatic hammer about three and one-half years.
Four fingers o f my left hand are numb, and there is no circulation in them In
cold weather. Both wrists feel as if sprained. At night I c?in not sleep very
well, and I wake up and feel that my arms are asleep.
EMPLOYEE NO 3 0 , AGE 5 1 .

I have been using the air hammer steadily about eight years.
The forefingers, and thumbs o f both hands are numb, and there is no cir­
culation in cold weather. Both thumbs are very sore to the touch at all times,
even when holding a book. The hammer also affects my left eye, which seems
to be blurred on certain days. I attribute this to the dust and air from the
hammer. My back, after a hard day’s work, gives me a great deal o f trouble,
especially after sitting down and on trying to rise. I feel this pain mostly in
the small o f my back.
EMPLOYEE NO. 3 1 , AGE 3 0 .

I have used the pneumatic hammer for the past three years on limestone and
three years prior on marble in New York City.
The four fingers and thumb of my left hand, up to the palm, are numb and
there is no circulation in them in the cold w eath er; the thumb and first finger
o f my right hand are affected the same way. When I lie down in bed my heart
seems to flutter. My legs, when I am in bed, are always tingling, a sort of a
deadening feeling running through them. I passed the insurance test for life
insurance four years ago and passed the examination o f the Metropolitan Life,
but since then this feeling o f numbness in my limbs has come, and I attribute
this to the constant use o f the air hammer. When holding a newspaper or book,
while reading, my arms frequently go to sleep, and it is necessary to drop them
in order to restore circulation.
EMPLOYEE NO. 3 2 , AGE 3 5 .

I have used the pneumatic hammer about seven years— five of these on hard
marble at Carthage, Mo., and two years on limestone.




26

PRELIMINARY INVESTIGATION BY THE BUREAU.

The thumb and four fingers o f my left hand and also the thumb and fore­
finger o f my right hand are numb, and there is no circulation in them in cold
weather. On my left hand this numbness extends back to my knuckles. My
nerves are also affected ; my eyes and the region above them seem to tingle and
burn. I f I sit with a book or newspaper and hold my hands up for any length
o f time— 10 minutes or more— both arms go to sleep. I then have to drop my
arms in order to get the circulation back again. The back o f my shoulders is
affected and seems numb, and I frequently have to get up at nights and rub
it. I have never been to see a physician regarding this trouble.
EMPLOYEE NO. 3 3 , AGE 3 2 .

I have been using the pneumatic hammer about 16 years.
The four fingers o f my left hand are numb in cold weather, and when in that
condition have no feeling in them. Last spring my wrist began swelling and
I consulted D r . ---------- in regard to it. He put splints on it and said I should
stop work. I stopped work three or four days and consulted him again, when my
hand was better. He was very much surprised. The doctor said, on my first
visit, “ I am afraid that the constant vibration o f the air hammer has caused
this swelling.” I have been working ever since and so far have had no trouble
with my wrist.
EMPLOYEE NO. 3 4 , AGE 5 3 .

I have been using the air hammer for six or seven years.
When my hands are idle they go to sleep and they are not sensitive to touch.
I have cut stone about 35 years, but previous to the time I began to use the air
hammer I never suffered any bad effects as a result o f the use o f mallet and
chisel.
EMPLOYEE NO. 3 5 , AGE 2 5 .

I have been using the pneumatic hammer a little over two years and a half.
The four fingers o f my left hand are numb up to and above the knuckles.
My left arm and shoulder frequently go to sleep, sometimes when I am working
and also at night. My hearing is a ffected; there is a continual hum in the ear
and left side o f the head, and I think this is caused by using the air hammer.
EMPLOYEE NO. 3 6 , AGE 2 7.

I have been using the pneumatic hammer about seven years.
The little finger and the next two fingers o f my left hand are numb. This is
felt more on cold mornings than at any other time. The left arm goes to sleep
at night and I can feel it je r k in g ; sometimes it wakes me up and sometimes it
does not. Sometimes when I use the rasp it cramps my hands so that I am
not able to let go o f the rasp.
EMPLOYEE NO. 3 7 , AGE 3 2 .

I have been using the air hammer about five years.
The four fingers o f my left hand are numb in cold weather and turn w hite;
this extends as far as the knuckles.
EMPLOYEE NO. 3 8 , AGE 4 8 .

I have been using the air hammer about 10 or 12 years past.
The fou r fingers and thumb o f my left hand are white and numb and are
very painful. When using this hammer and working without fire in the mill,




ATTITUDE OF INJURED EMPLOYEES.

27

I use a yarn glove and over this glove a lined leather mitten, and it is impos­
sible for me to keep my fingers from going numb and white. One winter I did
not work at stonecutting but was driving a team o f horses, and my left hand
hurt me just as badly as when I was using the air hammer. It was impossible
to keep the hand warm even with heavy mittens on. My left arm between the
shoulder and the fingers gets numb and feels as if it were paralyzed, and some­
times it takes me nearly half an hour to bring the circulation back again.
Sometimes this has happened two and three times a night. Sometimes my left
wrist is so affected that the join t seems pull«d in two, and I can hardly hold
the tool. I think that the air used in hammers is impure to breathe, as it
seems to me to be stagnated air, as it is confined so long, and I consider it
unhealthy.
EMPLOYEE NO. 3 9 , AGE 2 7 .

I have been using the air hammer about 1 } years.
The tips o f the fingers o f my left hand are n um b; I call them dead fingers.
About five years ago this numbness extended back to the knuckles, but, as the
years go by, gradually the numbness seems to go to the tip o f the fingers. The
only time this numbness affects me is when I use the 1-inch hammer. When
using the f-inch hammer I seem to feel no ill effects.
EMPLOYEE NO. 4 0 , AGE 2 3 .

I have been using the air hammer off and on about one year and a half.
The fou r fingers o f my left hand are numb and turn white in cold weather,
and this extends back to the knuckles. The index finger o f my right hand is
also affected the same way. I also have an aching pain in the shoulder and
the elbow joint o f my left arm.
EMPLOYEE NO. 4 1 , AGE 4 1 .

I have been using the air hammer about 10 years.
The fou r fingers o f my left hand are numb and turn white in cold weather,
and at times this extends as far as the elbow, making the arm feel as if it were
partially paralyzed, so that I can hardly grip a tool. The thumb and index
finger o f my right hand are affected the same as the left hand.
EMPLOYEE NO. 4 2 , AGE 3 9 .

I have been using the air hammer about six years.
My left arm, from the elbow to the shoulder, is very painful, and I have to
rub it in order to bring the circulation back into it. I never had rheumatism,
and this can not be the cause o f the pain in the arm. The pain comes very
frequently when I do other work or have my arm in a certain position, and
when it comes on is very severe. This pain has been very frequent in the past
two years.
EMPLOYEE NO. 4 3 , AGE 3 0 .

I have been using the air hammer about fou r years.
The four fingers, up to the knuckles o f my left hand, are cold and white and
without feeling— only in cold weather. My fingers have been this way for the
past two years. It takes some time— from BO to 45 minutes— to bring the cir­
culation back into them.




28

PRELIMINARY INVESTIGATION BY THE BUREAU.
EMPLOYEE NO. 4 4 , AGE 5 2 .

I have been using the air hammer about fou r years.
The four fingers o f my left hand are numb and turn white In cold w eath er;
on the last tw o fingers this condition extends to the palm o f the hand; the mid­
dle finger o f the right hand is affected the same way. I used the air ham­
mers on the capitol at Providence, R. I., but on this work w e used them to run
draft lines, and on heavy work we used the mallet, hammer, and point, and we
never even cleaned up the work with it.
EMPLOYEE NO. 4 5 , AGE 3 3 .

I have been using the air hammer for the past four years.
The fou r fingers, up to the knuckles, are numb, and in cold weather turn
white, and there is no circulation in them when white and cold. I can not use
the air hammer to work to any advantage when my hands get this way. So
far the air hammer has not affected me in any other way.
EMPLOYEE NO. 4 6 , AGE 5 4 .

I have used the air hammer about eight years.
The thumb and four fingers o f my left hand are numb, and this extends to
the palm o f my hand, and in cold weather they turn white and there is no life
in my fingers. When my fingers get this way they hurt. In the past year I
have felt the same kind of pains in my left arm and shoulder. This occurs
when I get out o f bed in the morning and continues until I begin to move them
about and get the circulation started, before I can get any life into them. I
can not work in very cold weather unless I get near a fire, because without the
heat my hand is not in condition for working.
EMPLOYEE NO. 4 7, AGE 2 8 .

I have been using the air hammer for about six or seven years.
The fingers o f both hands are numb, and in cold weather get white, and there
is no feeling in them.
EMPLOYEE NO. 4 8 . AGE 2 3 .

I have been using the air hammer about four years.
The four fingers of my left hand get numb as far up as the knuckles and in
cold weather get white, and I have to smack them together in order to get any
life into them. The hammer also affects the first finger of my right hand the
same way.
EMPLOYEE NO. 4 9 , AGE 2 1 .

I have been using the air hammer off and on for the past four years.
The first three fingers o f my left hand are numb and in cold weather get
white. When my fingers get cold I have no feeling in them, and it requires
rubbing in order to get the blood to circulating in them.
EMPLOYEE NO. 5 0 , AGE 3 4 .

I have been using the air hammer about 10 years.
The thumbs and the fingers o f both hands are numb, and I can not keep them
w arm ; they do not turn white. My right lung is affected and it has hurt mu
fo r the past three y e a r s ; the doctor says it is tuberculosis.




ATTITUDE OF INJURED EMPLOYEES.
,

29

EMPLOYEE NO. 5 1 , AGE 4 5 .

I have been using the air hammer for the past six years.
The fingers o f both hands are cramped and occasionally turn white in cold
weather. I am very nervous and the least excitement causes me to jump. I
think this nervousness is caused by the constant vibration o f the air hammer.
EMPLOYEE NO. 5 2 , AGE 3 1 .

I have been using the air hammer about eight years.
The fingers of both hands are numb and turn white in cold weather, and
when my fingers get cold they are very painful. I have been using the 1-inch
hammer, and do not feel the effects so much as from using the smaller ham­
mer— the f-inch size. Both feet, when in the same position any length o f time,
go to sleep; and at night I am so restless that I throw my arms about.
EMPLOYEE NO. 5 8 , AGE 6 2 .

I have been using the air hammer about seven years.
The four fingers and thumb o f my left hand, when cold, are entirely white
and numb and have no feeling in them and I can not button my shirt with
them. There is also a swelling in the wrist, but it is not very painful. At
night, in bed, when I turn over on my left side, my left arm goes to sleep or
gets numb from the shoulder to the tips o f the fingers, and I can not lie on this
side for over 15 to 20 minutes. The right hand is affected only in extremely
cold weather. I have cut stone for over 40 years with the mallet, and no such
symptoms were ever felt.
EMPLOYEE NO. 5 4 , AGE 4 5 .

I have been using the air hammer about six years.
The four fingers and thumb o f my left hand are numb and white, there is
no circulation in them in cold weather, and this numbness extends back as
far as the knuckles. When my fingers get cold and white, it takes considerable
rubbing and smacking together in order to bring back the circulation to them.
At night my sleep is affected, both arms seem to lose all feeling, and I fre­
quently have to get up and rub them. The worst work with the air hammer
is that o f tooling. At different times I have worked at this several weeks at a
time, without change, and this class o f work is harder than cutting different
patterns o f stone.
EMPLOYEE NO. 5 5 , AGE 2 6 .

I have been using the air hammer about six years.
The four fingers o f my* left hand are numb and there is no circulation in
them in cold weather. This is when they turn white. This affects my fingers
up to the knuckles. The index finger o f my right hand is also affected the
same way. I think my eyes are affected from the use o f the air hammer, as
I have to wear glasses, and the glasses are stained and scarred. I consulted
a doctor in 1912 and 1913, and he said my eyes were all cut up. When I go
in swimming in the summer months my fingers turn white and cold.
EMPLOYEE NO. 5 6 , AGE 4 0 .

I have been using the pneumatic hammer steadily about five years.
The four fingers o f my left hand and the thumb and forefinger o f my right
hand are numb and without circulation. This occurs only in cold w eather;




30

PRELIMINARY INVESTIGATION BY THE BUREAU.

in summer I get this numbness, but it is easily worked off in hot weather.
In the elbow o f my right arm there is a numbness, and a continual pain.
EMPLOYEE NO. 5 7 , AGE 2 8 .

I have been using the air hammer for the past three years.
The four fingers o f my left hand are numb and get white as far up as the
knuckles. The left arm and the elbow get cold and sting. The right hand
is also affected up to the first joint. The hammer also affects my right
shoulder, and in order to relieve the pain I have to raise my arms over my
head.
EMPLOYEE NO. 5 8 , AGE 3 1 .

I have used the air hammer five years.
The only effect I feel from the use o f the air hammer is that it makes the
fingers o f both hands white in cold weather.
EMPLOYEE NO. 5 9 , AGE 2 5.

I have used the air hammer for two years.
I have partial paralysis in three fingers on the left hand and can not stand
having my hand exposed in even the mildest cold weather, on account o f poor
circulation, which makes it a useless member in severe cold though protected
with heavy gloves.
EMPLOYEE NO. 6 0 , AGE 2 2 .

I have been using the air hammer for about five years.
The fingers o f both hands as far up as the knuckles are numb and in cold
weather get white. There is no feeling in them. It also affects my left arm
as far up as the shoulder. This arm goes to sleep when I put it in a certain
position.
EMPLOYEE NO. 6 1 , AGE 2 4 .

I have been using the air hammer for the past four and one-half years.
The fingers o f my left hand are numb and in cold weather get white and
cold. This occurs whether I use the hammer or not. The muscles o f my left
arm seem to be dead and are painful.
EMPLOYEE NO. 6 2 , AGE 2 8 .

I have used the air hammer tw o weeks.
feel numb.

It has made my arm cramp and

EMPLOYEE NO. 6 3 , AGE 2 3 .

I have used the air hammer five years.
Both o f my hands get cold and useless, and I have pains in my right shoulder
at night.
EMPLOYEE NO. 6 4 , AGE 3 7 .

'

I have been using the air hammer for nearly 10 years.
Both hands, including my thumbs, are numb and get white in cold weather.
W hen I am in bed at night my left arm goes to sleep and there is no feeling
in it.




ATTITUDE OF INJURED EMPLOYEES.

31

EMPLOYEE NO’ 6 5 , AGE 2T.

I have been using the air hammer constantly fo r the past six years.
On the left hand all the fingers are numb as far up as the knuckles and in cold
weather turn white. There is no feeling in them they get so cold. My left
arm aches at times.
EMPLOYEE NO. 6 6 , AGE 2 8 .

I have used the air hammer for six years.
I find the fingers o f both hands are affected by numbness to the extreme
on cold or damp mornings.
EMPLOYEE NO. 6 7 , AGE 3 1 .

I have used the air hammer about 16 years.
It has caused the blood to stop circulating in my hand and arm so that they
often get numb, and I have to stop and rub them several minutes at a time on
cold mornings in order to get circulation started again before I can resume
work. Sometimes my arm gets numb to the shoulder.
EMPLOYEE NO. 6 8 , AGE 3 6 .

I have been using the air hammer about five years.
Four fingers o f my left hand and the first three fingers o f my right hand are
numb as far as the knuckles; my left arm is numb and goes to sleep if held
in a certain position for any length o f time. My nerves are affected and I am
very irritable at nights after returning from work.

EMPLOYEES NOT INJURED BY THE AIR HAMMER.

Twenty-nine stonecutters state that they have felt no ill effects
from working with'the air hammer. Excluding one who did not
report on this point, the length of their experience with the hammer
ranges from 1 to 20 years, the average being 9.2 years. Almost twothirds (64.3 per cent) have used the hammer from 4 to 10 years and
nearly 39 per cent 10 years or more.
Twenty did not testify individually but signed a general statement
that the hammer had not been harmful to them and they favored it*s
continued use. O f the nine who made separate statements one says he
had trouble with his right shoulder and with his heart when work­
ing by the hand method, but since he has been using the pneumatic
hammer this trouble has disappeared; another states that he can
work without gloves in the coldest weather; and a third declares he
would leave the industry if compelled to go back to the old way be­
cause of the greater demands made on the strength by the hand tools.
Still another reports that he has never seen a stonecutter suffering
from any injury except the “ common ills that naturally follow the
occupation o f cutting stone ” ; he does not state what these “ common
ills ” are.




32

PRELIMINARY INVESTIGATION BY THE BUREAU.
STATEMENTS OF MEN NOT INJURED.
EMPLOYEE NO. I.

I hereby certify that I have used an air hammer for 17 years and have never
felt any injurious effects, and prefer to use it instead o f the old method of
hand tools.
EMPLOYEE NO. I I, AGE 4 2 .

I have been using the air hammer about six or seven years.
The fingers o f my left hand.turn white in cold weather, but my fingers do
not get numb. Before using the air hammer and while using the mallet and
hand hammer I used to have such pains in my right shoulder that I could
hardly put my coat on or take it off. The work is not half as hard with the
air hammer as it was with the mallet. My heart used to bother me when I
used the hand tools, but since using the air hammer I do not feel that bother.
EMPLOYEE NO. I l l , AGE 3 5 .

I have been using the air hammer about 13 or 14 years.
I have never had any ill effects from using the hammer. I have done carving
and during the past 11 years have cut stone, using the air hammer nearly all
the time.
EMPLOYEE NO. IV.

I have been in the mills as a stonecutter for the past 14 years— eight years
in the monumental business and six years at my present place. During all this
time, I have been using pneumatic tools in my work. The f-inch tool is used
most, but occasionally I use the 1-inch hammer.
During my 14 years o f using the pneumatic tools, I have not found the air
hammers to be injurious. They create a finer dust than the mallet and chisel
but I have never found this dust to injure me in any way. These hammers
have never affected me with paralysis or anything on account o f their use. In
fact, I have njot found their use to be detrimental in any way. I f these were to
be discarded, I fully believe that I would quit the business. I have used these
hammers during practically all the time I have been in the business, and I do
not feel that I could stand wielding the mallet all day now. I can do much
more work and more satisfactory work with the air hammers, so that it would
be a hindrance rather than a benefit to me to lay them aside. Personally, I
am in favor o f the air hammer for cutting limestone.
EMPLOYEE NO. V.

I have used air hammers for six years and can positively say they have
never hurt me nor my health.
EMPLOYEE NO. VI.

I have continuously used pneumatic tools for carving fo r a period o f 20
years, and have never experienced, to my knowledge, any ill effects from same.
Nor have I, during that time, seen anyone suffering from any other than the
common causes or ills that naturally follow the occupation o f cutting stone.
EMPLOYEE NO. VII.

I have been using the air hammer for about 17 years and have never suf­
fered any ill effects as a result o f its use, nor have I ever known o f anyone who
suffered any permanent injury from the use o f the air hammer.




ATTITUDE OF EMPLOYEES NOT INJURED.

33

EMPLOYEE NO. V III, AGE 4 4 .

I have been using the air hammer about 17 years, nearly continuously.
The hammer has never affected me in any way. I can work with it in the
coldest weather without gloves. I use the |-inch, 1-inch, and the pistol-grip
1-inch Boyer. I have used the pistol-grip hammer for about six years.
EMPLOYEE NO. IX .

[Agent found this man at home sick. He said that he had rheumatism in
the right shoulder and arm, and that this was brought on by an attack of
grippe and was not caused by the use o f the air hammer. H is hands do not
get numb nor do they get white in cold weather. H e has been out o f the city
on different jobs o f erection o f stonework and does not use the air hammer
constantly.]
no. x.
[Signed by 20 em ployees.]

W e whose signatures are attached hereto are practical and working stone­
cutters and are users o f the air hammers, having employed them in our work
covering the periods named, follow ing our signatures, and have not found them
injurious to our health or otherwise, and we favor their continued use for
cutting and carving stone.
[The above statement was follow ed by the signatures o f the 20 men and the
number o f years each had used the pneumatic hammer. The years o f expe­
rience range from 1 to 20, the average being 7^ years.]

ATTITUDE OF THE EMPLOYERS.
Sixteen firms report an experience in the stone industry of from
12 to 45 years, and with the pneumatic hammer of from 5 to 25 years.
One firm states that there is no discrimination in the district
against a workman because of his lack of experience with the ham­
mer; one that the use of the hammer is not compulsory. Seven
others make the point that the hammer is only a finishing tool and
a good deal of the work can be done by hand, thus placing the blame
on the stonecutter if continuous use of the hammer injures him. One
employer thinks that the 4 foreman in all mills should see that the
4
mash hammer and mallet are not discarded and insist on their use
where expedient.”
Three employers assert that, so far as their knowledge and experi­
ence go, there have been no instances of workmen being “ perma­
nently ” injured or disabled; two that there have been no 4 serious”
4
effects; five that none have been 4 injured ” or disabled; three that
4
they know of no case of paralysis, tuberculosis, or insanity (as the
case may be) ; and one that he knows of no 6 death ” from tubercu­
4
losis. Two confine themselves to the statement that there have been
u no complaints,” and the superintendent of one of these adds that
he does not know of a 4 single case of paralysis or tuberculosis.” One
4
1§476°— 18— Bull. 236------ 3




34

PRELIMINARY INVESTIGATION BY THE BUREAU.

employer makes the general statement that “ this invention is a de­
cided success if not abused by the workmen themselves.” Six of
these firms qualify their statements as to the harmlessness of the air
hammer by making it conditional on the proper use of the tool.
Eight of the 17 companies mentioned above claim that the work­
men themselves prefer the air hammer to the hand tools, as shown
by the fact that they refuse to work by hand, and complain or go
home when the compressor breaks down.
Only 5 of these 17 employers specifically admit that there are
detrimental results of work with the pneumatic machine, and these
minimize the evils. One of these says he understands that the three
small fingers of the left hand have “ poor blood circulation and some­
times become null
one that the fingers do get cold but not more
so than by the old method; one that the fingers get chilled on a cold
day but otherwise there is no harm; one that the “ abuse ” of the
hammer causes the hand to become “ cold and lifeless” in cold
weather; and the last that there is “ some slight disturbance of the
circulation of the hand that holds the tool.”
Employers attribute the men’s complaint to various motives. One
says the cause is the “ natural dislike o f the workman to try a new
method ;” one that the cutters oppose the hammer because it is a
machine; two that the men fear the hammer will displace labor or
think its abolition will mean “ work for more men” ; one that the
movement is in line with the opposition of the printers to the type­
setting machine; one that the ‘complaint is intended merely as a
“ help to higher wages; ” and one that the men are trying to “ block
the wheels o f progress.”
Four employers plead the necessity of the hammer on the ground
of better work produced with i t ; and eight others because more work
can be done when it is used, or for the reason that it cuts down the
cost o f production and enables them to compete with makers o f
artificial stone. Two of these firms claim that the abolition o f the
machine would be disastrous to the business; while two say it would
cause serious injury to it.
In order that certain firms should not be counted twice, statements
No. 1 and No. 2, which follow, have been disregarded in the pre­
ceding discussion. Both are from employers’ associations. State­
ment No. 1 discusses only the question of wage rates. Statement No.
2 is from an organization of 19 firms, of whom all but 3 also made
individual statements, and covers most of the points dwelt upon by
the various employers. In it the stand is taken that the function
of the hammer is well defined, and if in practice the cutter misuses it,
that is no fault of the employer; that numbing resulting from “ chok­
ing ” the exhaust with the thumb can not be held chargeable to the
hammer; that conditions in the trade are much better than in




ATTITUDE OF EMPLOYERS.

35

structural-iron work and yet no complaint has been heard from these
employees; tod that the use of the air hammer is part of the labor
contract and is necessary in the business to keep down the cost o 1
production.
The statements received from the employers are given herewith:
STATEMENTS OF EMPLOYERS.
NO. 1.

[An employers’ association.]

I duly received your favor o f the 13th requesting additional inform ation in
connection with the air-hammer investigation. W ould have replied sooner but
for the fact that I wanted to develop fairly exact figures for this proposition.
I am unable to take this matter back as far as 1880, but believe it can safely
be assumed that the scale o f wages antedating 1900 was probably much on the
same level. The only change there might be would be in the number o f hours.
W orking hours were a pretty elastic proposition previous to the last decade,
as is a well-known fact.
I have before me a newspaper clipping o f one o f the Bedford papers which
shows that in March, 1900, the follow ing scale o f wages applied:
Planer men, 20 to 25 cents per h o u r ; head sawyers, 20 cents per hour.
In 1903 these classifications are quoted as fo llo w s :
Planer men, 28$ cents per h our; head sawyers, 22$ cents per hour.
I have before me the agreement between the Bedford Stone Club and the
Stone Planer Men’s Union No. 12866, o f Bedford and vicinity. As explained
to you in person, this union is not affiliated with the American Federation o f
Labor. Agreement in question is dated April 6, 1915, and runs for a term of
five years, except as to wages, which are subject to annual adjustm ent
The agreement establishes 59 hours as a week’s work, and overtime is al­
lowed up to 12 hours per day in emergencies with the provision that emergencies
shall not exceed 6 days in 60 days.
The wages are established as fo llo w s :
Section 14 o f agreement. It is agreed that the wages for planer men, lathe
men, header men, and shaper men w in be 35 cents per hour while working on
planers, lathes, headers, and shapers, and when operating circular planers to
be paid 40 cents per hour.
Since that time the scale has been advanced from 35 cents to 37$ cents and
is due t% be advanced to 40 cents on September 1, 1917, to stand at the lastnamed figure until March 31, 1919.
Workmen on diamond saws were paid, until about a year ago, 27 cents per
hour and are now on a basis o f 30 cents per hour, likewise being on a basis
of 59 hours per week.
You understand, o f course, that the operation o f a circular diamond saw
does not involve nearly the expertness required o f a planer man or lathe man.
You are correct in your assumption that carvers are paid $1 per day more
than the stonecutters.
NO. 2.

[Written in behalf of 19 member flrms.I

Following our conversation yesterday in regard to the use o f pneumatic
tools in cut-stone establishments, I wish to submit the follow in g :




36

PRELIMINARY INVESTIGATION BY THE BUREAU.

The employment o f so-called air hammers is simply a matter o f evolution in
the stone-working trade exactly as is the use o f planers, circular saws, lathes,
and any o f the other numerous devices without which the business could not
exist to-day.
Just as all these other machines named serve their particular purpose and
were intended to be used in a certain manner, just so the function o f the air
hammer is well defined in theory. I f in practice it is misused, that is a propo­
sition over which investigation will show the employer has no control. Many
employees have acquired the habit of using the air hammer indiscriminately
and without regard for the manner in which it is supposed to be handled.
The air hammer was never intended for se-eall-ed “ roughing out ” or “ coarse
work ” \ it was intended for the lighter and finishing operations. It is to the
employer’s advantage to haVe the correct hand tools used for roughing out, etc.,
rather than air, because compressed air is one o f the most expensive agencies
in any shop.
Many stonecutters, however, use the air hammer contrary to the principles
which should properly govern. Some o f them seem to think that it is easier
and requires less exertion to use the air tool than to use the hand tool. Like­
wise few er and few er stonecutters carry a properly equipped kit. The em­
ployer furnishes the air-tool equipment, hence it saves the stonecutter money
to operate with an incomplete kit o f his own, not containing the proper hand
tools. He simply depends on the employer for the necessary equipment by way
o f air tools.
An incidental practice o f many stonecutters in the use o f the air hammer is
choking the exhaust with their thumb for the purpose o f lightening the stroke.
This choking o f exhaust sends the air forw ard and discharges it alongside the
bit, directly onto the fingers o f the operative. Numbing resulting from such
misuse o f the tool is o f course entirely chargeable to the man and not to the
air hammer.
W ould also state here that the claim that the dust created by these machines
is injurious adds nothing so far as the general working conditions in the trade
are concerned. Stone workers have at all times, centuries before machines
were in use, been more susceptible to pulmonary diseases than workers in most
other vocations. This condition, however, does not exist so much in the lime­
stone industry as it does in the sandstone and granite trades. Limestone,
particularly oolitic limestone, has not the physical characteristics which make
other stone dusts so deleterious. It is more than likely that the air hammer
would tend to better these particular conditions, inasmuch as when the air
hammer is properly used the exhaust blows the dust away from the worker.
It thus has no opportunity to hang suspended about him in the shop’s atmos­
phere.
W e are convinced that upon an unbiased investigation o f cases o f paralysis
and the like which it is charged are directly attributable to the use o f the air
hammer, they w ill be found to have their source in an entirely different cause.
I f any person endeavoring to use an air hammer and apparently in good health
generally notices evil effects from the operation, it can only be sai€ that he is
a misfit in the trade. 'W e would refer in this connection to occupational dis­
eases in other branches o f industry. The wool picker is subject to anthrax,
the lead-smelter employee to lead poisoning, the painter and glass blower to
their peculiar hazards. But because o f these conditions, must the use o f wool
be discontinued, the refining o f lead stopped, and every other vocation elimi­
nated in the execution o f which exist inherent risks for a few isolated and
peculiarly susceptible w orkers?




ATTITUDE OF EMPLOYERS.

37

I f the use o f the air hammer is made impossible in the stone industry and
resort had to antiquated methods depending upon hand tools entirely, the cost
o f stone w ill rise to such an extent as to make it alarmingly difficult, i f not
entirely impossible, to compete with the numerous substitutes which already
have encroached so disastrously on the natural product’s rightful markets.
In carving, air tools are'as necessary as the skill o f the carver himself. Take
away the air tool and the carving branch o f the craft w ill vanish.
The stone industry probably employs but a small fraction o f all the air
hammers and similar devices in use in the United States to-day. It is a
peculiar but significant fact that no complaint has been known to have ueen
filed by structural-iron workers and the labor element in shipyards. Yet there
are far more air hammers employed in these tw o branches o f industry than in
ours. At the same time the use o f air hammers by steel workers and shipyard
employees is subject to many more unfavorable conditions in general than
prevail in the average cut-stone establishment to-day. Reference need be had
here only to the fact that the m ajority of cut-stone establishments are inclosed
and surroundings made as comfortable as possible for the employee. Compare
with such working conditions circumstances surrounding the structural-iron
workers engaged in building construction and in shipyards.
It has been said that the structural-iron worker does not use the air tool
as continuously as does the stonecutter. Comparison will show, however, that
the structural-iron worker does actually use his tool practically without inter­
ruption, whereas the stonecutter, if he does so, is acting contrary to what is
expected o f him and is follow ing only the dictates o f his own convenience.
W e contend that it is eminently unfair that the Journeymen Stone Cutters*
Association o f the United States should attack the use of the air hammer in
our division o f the industry, while never a murmur o f complaint has been
heard from the marble and granite working part o f the trade, yet we dare say
that marble and granite shops employ a far greater number o f air hammers
than we do.
The history o f the rise in wages in the Indiana limestone district is approx­
imately as follow s:
1898_________
190 8
190 9
191 3
191 4
191 5
1917_________

35 cents per hour.
50 cents per hour.
50 cents; 56£ cents; 62£ cents per hour (sliding scale).
56* cents per hour.
60 cents per hour.
62^ cents per hour.
67£ cents per hour.

The foregoing schedule is not exact, particularly as to time, but is suffificiently so to indicate that the constant rise in the amount o f remuneration
paid the stonecutter in this district is such as w ill serve to prove that the in­
dustry has given full recognition to the workmen, while it was developing its
mechanical equipment on m odem lines. Another factor to be considered is
that the regularity o f employment has become such as to do away nearly
altogether with the losses o f time which form erly were so prevalent. This
regulation o f employment is attributable to the creation of inclosed shops and
markets which are sufficiently diversified to make possible operations the year
round. In other words, only a short time ago a stonecutter earned 25 per cent
less than to-day and worked perhaps nine months in the year, where at the
present time he rarely loses more than one month in any twelve, if that much.
The operators have a working agreement with the Journeymen Stone Cutters’
Association o f North Am erica and Canada which has some time yet to run




38

PRELIMINARY INVESTIGATION BY THE BUREAU.

and provides, among other things, that the use o f machinery shall not be
interfered with. This attack on the air hammer is an infraction o f a contract
made by the employers in good faith. It is an attack actuated solely by the
desire to retard the economical development o f the stone industry for the
single purpose o f making room for more workmen by elimination .of a suc­
cessful and necessary mechanical device. The elimination o f the air hammer
will, through increased operating cost, curtail the use o f stone to such an ex­
tent that far more workmen w ill lose their employment from that cause than
will find a ;*ew berth because handwork supplants efficient mechanical opera­
tion with air hammers.
The primary purpose o f the attack being made on the air hammer by the Jour­
neymen Stone Cutters’ Association o f North America is to retard and prevent,
if possible, the logical development o f the industry. This can not be accom­
plished any more than similar attempts in the United States and abroad have
succeeded in other branches o f commerce where the employment o f laborsaving machines and devices was a vital factor.
EMPLOYER NO.

3.

In reply to yours o f the 15th, the air hammer has been in use in our plant for
about six years. W hile it has never been compulsory for the men to use this
tool, we consider it very efficient on some classes o f w ork ; on other classes
we do not believe the tool pays, as the rough work can best be done with the
hand tools.
The rough work is reported to have the injurious effect on the men, if there
is any, and the men being the sole judges as to what class o f w ork the air
tool is best adapted, have abused the use, and their trying to use it continu­
ously on all classes o f work seems to have caused all the trouble about the
air tool.
When first installed in our plant w e only had air enough for two tools, and
the men continually urged us to get more tools and a larger compressor, and
they complain when the compressor is out o f order.
W e believe the main idea in doing away with the air hammers is to make
work for more men, reducing the efficiency o f the men employed and greatly
increasing the cost o f cutting some classes o f work, which would be ruinous
to our business, as our product comes in competition with other building ma­
terials, such as art stone and terra cotta.
A few years ago the stonecutters legislated against the planers, and in some
cities succeeded in doing away with them, but finally found they had come
to stay, as the air tools have.
W e know o f no serious effect on the health o f the men from the use o f
the air hammers, and if put out o f use some men now cutting stone would have
to leave the trade as they can not cut stone with a mallet. As the writer
is a stonecutter, I speak from personal experience.
EMPLOYER NO. 4.

Complying with your request o f the 7th instant regarding this company’s
opinion, also the personal opinion o f the writer, regarding the use o f the
pneumatic, or air, hammer as applied to the cutting o f stone; and further
dealing with the subject as to whether or not this hammer is injurious to
the general health o f the operator, in that it ultimately causes paralysis,
tuberculosis, and a general breakdown o f the nervous system.




ATTITUDE OF EMPLOYEES.

39

Answering the above, can state there is no such condition existing in this
Industry as applied to this fie ld ; neither do we know o f a single instance
where physical disability has been traced to the use o f this hammer. Men
here use it almost universally by choice, and our judgment would be, if one
is elected to cut stone, the pneumatic hammer not only increases the operator’s
efficiency, but serves to make it easier for him to maintain his efficiency
rather than add additional hardship.
The above would incorporate our opinion based upon many years in this
field, and includes the life o f the air hammer in cutting stone.
In conclusion can state should your department see fit to call upon us further,
we w ill be pleased to serve you in any way possible.
EMPLOYER NO. 5.

W e have used the air hammers in the cut-stone business for the last five
years, and, to our knowledge, there has been no one permanently injured or
disabled on account o f using them. W e do know that the three small fingers
o f the hand in which the stonecutter holds the tool (but not the hammer) have
poor blood circulation and sometimes become null. These air hammers are a
great necessity in the Indiana limestone business, as by using them you can
procure a better finish o f stone,
EMPLOYER NO. 0.

W e have been using air tools in the manufacture o f exterior building stone
for about eight years, during which time we have used from 2 to 20 air ham*
mers, and in no case do we know o f any o f our employees who have been
permanently injured from the use o f the same.
W e believe that the stonecutters do about 20 per cent more work with the air
hammer than by the old methods.
The conditions under which our employees are now working are much better
than they were 10 years ago, the shops in the Bedford and Bloomington dis­
tricts being all practically inclosed and heated.
EMPLOYER NO. 7.

W e have before us the statement o f Mr. Griggs, president o f the stonecutters’
union, relative to the injurious effects o f stone dust and the air hammer. H is
statement is that tubercular affections result from the inhalation o f stone
dust, and that paralysis and insanity follow quite generally the use o f the air
hammer.
W e have been in the stone business here some 25 years, the writer the same
length o f time. Never have we known o f a case o f paralysis or insanity among
stonecutters in this district. Nor do we know o f a case o f tuberculosis. In
fact it has always seemed to us that the stonecutters were a particularly healthy
and prosperous class o f workmen. W e understand there is a more or less na­
tional m ovem ent1 looking to the settlement o f the health issue involved in the
use o f the air hammer.
EMPLOYER NO. 8.

Considerable agitation has been started in this district recently by stone­
cutters to abolish the air hammer, as used in connection with our stonecutting
operations, on the ground that it is harmful to the operator. I have cut stone
m yself for 12 years in the old way and have been a daily observer o f the new




1 See Appendix B of this report.

40

PRELIMINARY INVESTIGATION BY THE BUREAU.

way (air ham m er), and I deny that any injury is caused by the use o f the air
hammer.
I have interviewed any number o f cutters using them and have yet to find one
who said it hurt him more than the old method.
It is claimed that they get consumption from the d u st Well, I have eaten
considerable myself without the aid o f the air hammer.
Few men get consumption from working limestone, with or without the air
hammer. By far the larger number that suffer from this disease are sand­
stone workers, because there is grit in sandstone that is harmful. So why
blame the air hammer when it is not employed in cutting sandstone? The
claim is put forth that the little finger and the tips o f the others become cold
from holding the hammer. This is true; but, believe me, your fingers get
cold, too, by the old method, as I can testify by 12 years’ experience.
Just to illustrate what our cutters think o f the air hammer, I w ill call your
attention to the fact that every time our compressor breaks down the cutters,
rather than work with their old hand tools for an hour or two, will quit and go
Lome until repairs are effected.
To me this is evidence that agitation is all by men outside o f this district who
never worked with an air hammer and who are always against a tool because it
is a machine, if for no other reason; and this, too, notwithstanding that the
use o f these tools enables us to cheapen nature’s best building material to a
point where it is possible to compete with substitutes that are manufactured
nowadays.
In summing up, I think that there is more or less abuse o f this little tool by the
cutters in trying to remove too much rough with it, instead o f using the hand
tools to do so and just using the air tool to clean up with. I believe it w ill
be necessary for our two associations to get together and form ulate w orking rules
that w ill eliminate some o f this trouble, as it would now be a serious loss to us
to abolish this tool.
EMPLOYEE NO. 9.

I am an employer of stonecutters and am a practical stonecutter myself. I
have been a resident o f Bedford off and on for 34 years, and have been an
employer o f stonecutters for 20 years and have seen the development o f the air*
hammer in the stone industry o f Bedford and vicinity. The company o f which
I am manager has used the air hammer for about eight years.
Having learned my trade using mallet and hammer, I was somewhat preju­
diced against the air hammer not because o f any injury it would do the user—
as that was something I had not heard o f or heard mentioned until late last
fall— but the natural dislike o f a man having learned his trade in a certain
way to adopting a new method.
I am at present heartily in favor o f the air hammer, as I find the stone­
cutters are more efficient by its u se; and the more skillful the man is in the
use o f the hammer, the more he is in favor o f continuing its use in cutting
and carving stone. The objection to its use is from men who have always used
the mallet and chisel and do not take kindly to a new method.
I do not know o f any discrimination being made against anyone in this
district because o f their lack o f experience in the use o f the air hammer, but
I do know o f at least two men here who cut stone with me right here in 1883
and are still here cutting stone.
I do not know o f anyone, and have never heard o f anyone, being injured
by the use o f the air hammer, but I have heard plenty o f complaints from users
of the air hammer against any effort to deprive them o f its use in cutting and
carving stone.




ATTITUDE OF EMPLOYERS.

41

EMPLOYER NO. 10.

W e have read with care the address o f Mr. Griggs, president o f the Journey­
men Stone Cutters’ Association o f North America, at the annual business meet­
ing of the American Association for Labor Legislation, held in Columbus, Ohio,
I >ecember 29, 1916.
We do not agree with Mr. Griggs in his statement that the members of his
•association are more or less subject to tuberculosis. The writer has been in
charge o f stone mills in which stonecutters have been employed, for the past
25 years, and I can not recall one single case where a cutter’s death was caused
by this disease. I particularly refer to cutters who have been at work on
Indiana limestone. I have heard it said o f cutters in the sandstone district.
W ith reference to the use o f the air hammer, I was personally acquainted
with and employed for a time, R ----------D------------, the cutter who Mr. Griggs
RtntfTs died from the results of having used the air hammer in cutting stone.
Mr. D----------, I recall it, used the air hammer for about 3 or 4 years, and yet
we have men in our employ at this present time who have been using the air
hammer for the past 20 years, and in conversation with them they have advised
me that they much prefer the air hammer to the mallet and chisel, stating
that by using the air hammer their work is very much lightened. It is true
that a cutter can do considerably more work in some classes with the air
hammer than with the mallet and chisel, but I find that the cutter becomes
so attached to the air hammer that he uses it on work on which the mallet
and chisel are best adapted, and I have personally objected to cutters employed
in our plants using the air hammer on heavy work. It is our desire that the
stonecutter use this air hammer only in cutting light work or finishing and
cleaning up, but I find that the cutter prefers to be left alone and allowed to
use his own judgment in the use of the air hammer, and, as stated above, he
will invariably use it on work for which it is not intended and thereby disre­
gard our instructions.
I also wish to call your attention to a pamphlet which I attach herewith
nnd which you will please note has been issued by the manufacturers of an
imitation stone. I stated above that more work can be done with the air
hammer than with the mallet and chisel, and it is quite necessary that it
should be so when you take into consideration the fact that we are competing
with this imitation stone. It is necessary that we adopt more efficient ways
in the cutting o f our material so as to compete with the manufacturers o f imi­
tation stone. In conclusion I repeat that it is absurd for Mr. Griggs to advise
the American Association for Labor Legislation that such damaging results
are being obtained by the use o f the air hammer in this district.
EMPLOYER NO.

11.

With reference to the use o f the air hammer, w ill say that the first air
hammer that was used in cutting stone in Bedford was introduced in my mill
in 1896. They have been in constant use for 21 years, and I know o f no disabil­
ity caused by their use to anyone in my employ.
W e naturally wonder why the use o f this tool is complained o f in connection
with stonecutting as injurious, when there has been no complaint from steel
workers and other industries that use this tool.
W e think this complaint has been started only as a help to higher wages
and is not n just complaint, nor do we consider this tool injurious to the health
of the users.




42

PRELIMINARY INVESTIGATION BY THE BUREAU.
EMPLOYER NO.

12.

At your request, as to whether the air hammer as used by stonecutters is
injurious to their health or not, we wish to make the follow ing statements in
reference to the use o f compressed air as applied to stonecutting, which is our
honest and candid opinion based on 15 years’ experience in almost daily contact
with the use o f stonecutters’ air tools.
W e have heard that stonecutters have said that the air tool hurts them. W e
have also asked a great many if the air tool affected their health, and have
been advised that, outside o f chilling their fingers on a cold day, it did them no
harm. They have also expressed themselves in private (not for publication)
that they thought the use o f the air tool now to be absolutely necessary. It
enabled them to turn out more work with less physical exertion than the mallet
and hammer. W e have never known o f a case where a stonecutter was in any
way physically injured by the use o f the air tool.
The air hammer, as used in our plants, is a finishing tool, but the cutters will
persist, o f their own accord, in using it for heavy work, which can not be done
any quicker with the air hammer than with a hammer and point.
The worst complaint we have had about the air hammer is the water that
gets in the pipes and comes through the tool, keeping it cold and wet in cold
weather. W e are anxious and willing to find out and adopt any practical
method to overcome this. W e are now, as an experiment, contemplating run­
ning the air-pipe main line through a heated coil, to see if the heat w ill not
dry up the moisture in the pipe and keep the air warm until it reaches the tool.
In conclusion, the air hammer, in our opinion, while it is a labor saver on
elaborate work, is also a promoter o f the use o f stone. Its use is a progressive
step in the wider use o f stone for construction and ornamental purposes.
EMPLOYER NO. 1 3 .

R eferring to your request for our opinion as to the use o f air tools producing
tuberculosis, insanity, and paralysis, beg to say we have used air tools fo r over
25 years in our plants and have yet to learn o f a single case o f any o f the above
maladies being rightfully chargeable to the use o f the air tool. W e have
cutters who have been in our employ practically the entire period and are
and have been using this tool with no ill effects whatever.
It is one o f the best, if not the best, labor-saving devices in our business and
would work an irreparable injury to the cut-stone business if abandoned or
restricted in its proper and legitimate use. W e feel confident that a careful
medical investigation pf history o f those cases cited by the stonecutters’ union
regarding the above-named diseases will in each instance result in the air tool
being found “ not guilty ” o f the charge laid against it. The w riter’s personal
knowledge and observation have convinced me o f this irrefutable fact, and we
challenge the opponent o f the use o f the air tool to successfully disprove this
statement.
The use o f this air tool permits stone to be used where the expense o f doing
the work by hand, which can be done by air tools, would prevent the use o f
stone en tirely ; and were its use prohibited to-day there would be less stone­
cutters employed than at present, as soon as the present contracts for cut stone
could be finished.
The objection to the air tool is founded on a short-sighted policy o f trying
to block the wheels o f progress. These same men, had they been canal drivers
or stage drivers in the days o f the canal and stagecoach, would have opposed
the railroads as they oppose the air tool, and from the same mistakable and
selfish viewpoint. W e consider the air tool a blessing— not a curse.




ATTITUDE OF EMPLOYERS.

43

EMPLOYER NO. 14.

Permit me to say that I have been in touch with this tool since its introduc­
tion, in a general way having assisted Mr. W illiam Pascoe to install complete
plant for the Norcross Bros. Co., at Providence, R. I., 18 years ago. This plant
consisted o f 36 hand machines, designated at that time as class A, B, and C
tools, their piston capacity being I inch, | inch, and 1 inch. In addition to this,
we also installed four hoists o f 5 tons each. I merely state these facts for the
satisfaction o f any inquirer as to my ability to speak and talk of my experiences
in handling these machines. This plant referred to was installed by the Wolstencroft Co., o f Philadelphia, Pa., I, myself, being employed by the Norcross Co.
The use o f hand tools up to 1 inch is positively harm less; as out o f the
thousands o f men I know who have used this tool I have yet to see the man
who has been permanently injured in any way, who has made a study o f the
proper method o f handling the machine and, with an unbiased mind, gone about
to learn its proper use. I have had criticisms from a few who had grown so
much accustomed to the old method that they had tubercular trouble the day
after they began the use o f the machine. They could not master it because they
did not mean to master i t
When operating a pneumatic hammer the operator should always keep the
exhaust from the valve pointed straight up into the atmosphere, in order that
the air from same w ill not play on the body o f the operator.
As an explanation: On practically all hose connections there is a shut-off
valve which controls the operation o f machine. When the operator completes
large member, or rather wishes to reduce the strength or weight o f blow de­
livered by machine, he muffles the exhaust o f machine by turning it around far
enough so that the exhaust is covered, either by placing the thumb on hole or by
allowing it to lay in hand between thumb and forefinger. This compels back­
firing. In other words, the exhaust is compelled to find exit at lower end o f
machine, through small oil slot cut in inner chamber. This air blowing on left
hand which operates the chisel is the one affected. The hand holding the ma­
chine is never affected. This abuse causes the fingers o f the left hand, in cold
weather, to get cold and lifeless, remaining until proper circulation o f entire
body has been attained. Otherwise the anatomy is unharmed.
I f the use o f this machine was harmful it would affect the hand holding the
machine, but this is not the case. This machine, when properly and scientifi­
cally operated, is a help to the stonecutter and, like everything else in space, is
harmful when abused. It is the abuse o f the machine and not the use. This
condition, I believe, is getting better, as the younger man is more progressive
and learns to use it properly. The foreman in all mills should see that the
mash hammer and mallet are not discarded and insist on their use where ex­
pedient. The pneumatic hammer is then a wonderful help to a willing worker.
EMPLOYER NO. 1 5 .

In reply to your valued and interesting favor o f February 1, beg to say
that we must acknowledge that we have never conducted an investigation
as to the effect o f the use o f the air hammer stonecutting tool on the health
o f the workman or workmen using same. However, w e can positively state
that at no time have any o f our workmen complained to us in person or in
writing that said tool was injuring their health in any way. W e never heard o f
the injurious effects o f the use o f the tool except from Mr. Griggs. We earnestly
believe that the statements made by the said Mr. Griggs should not be taken
at their face value until duly verified by your department.




44

PRELIMINARY INVESTIGATION BY THE BUREAU.

Apropos of this subject, we respectfully direct your attention to an article
published this year in the January Stone, on page 23. This publication is de­
voted exclusively to the interests o f the stone industry, and is edited by Mr.
Frank A. Lent, 258 Broadway, New York. W e are taking the liberty o f mailing
to you our January copy o f this publication.
I f at any future date we can be o f service to you or your department please
command us.
[The follow ing is the agent’s statement o f the personal opinion o f the super­
intendent o f the above firm :]
The superintendent o f the above company says he does not know o f a single
case o f paralysis or tuberculosis due to working in a stone mill. He attributes
the protest against the use o f the air hammer to the fear o f the displacement
o f labor, which fear is unfounded because the introduction o f the air hammer
has made more wT
ork, given employment to more men, simply because it has
cheapened the product, thus enabling them— the stone manufacturers— to com­
pete with the producers o f imitations and substitutes.
He further states that the air hammer is intended only for carving, clean­
ing up, etc., and not for pointing or roughing ou t; but, regardless o f advice
to the men in this respect, they use the air hammer for this heavy work. The
bad effect, if any, is due to this misuse o f the hammer.
The company will, another year, install an arrangement for heating the air
in the hammer.
EMPLOYEE NO. 1 6 .

Have been in the stonecutting business for about 25 years, and the air
hammer has been operated about 8 years, during which time I have never
had brought to my attention any serious troubles caused by the use o f the
air hammer.
It has been observed that there is some slight disturbance o f the circula% tion 6f the hand that holds the tool, which is due to the abuse o f the use of
the tool. The tool could be laid aside and the hand method used and do just
as much work on certain kinds o f w o r k ; but, owing to the fact that they
do not like to exert themselves, they— the stonecutters— continue to use the
air tool.
The air hammer w ill do at least, on an average, about 25 per cent more
than the hand method, and at the same time better work is done by using
the air hammer than by the hand method. There is less dust with the air
hammer than there is by the hand method, because the exhaust on the air
hammer keeps the dust moving constantly.
EMPLOYER NO. 1 7 .

In reply to the statements o f Mr. Griggs, o f the stonecutters’ union, relative
to the injurious effects o f the stone dust on the workmen in bringing on
tubercular troubles and the air hammer in bringing on paralysis and insanity,
would say I have been engaged in the producing and working o f Indiana lime­
stone for the past 45 years, and, so far as observation has gone on the
tubercular question, there is no basis for such a statement from working Indiana
limestone. I know nothing o f the effect from working others. At this time
I can not recall a single case o f tuberculosis from any workman o f stone in
my 45 years’ experience.
My air-hammer experience is not for so long a period, but I have been con­
versant with it for the past 10 y ears; and, so far as I know, there has not




ATTITUDE OF EMPLOYERS.

45

been a case o f paralysis or insanity resulting from its u se; and from my in­
vestigations I feel perfectly safe in saying there is no higher percentage of
paralysis or insanity among the men who use the air hammers than there is
among men who have never used them. Personally, I do not know o f a single
case, and the only case I have heard o f is the one mentioned by you, which I
have not investigated as yet.
I was a member o f a committee from the Bedford Stone Club to meet with a
committee o f stonecutters from what is known as the Bedford Stone Belt
Conference,1 consisting o f the local organization o f Bedford, Bloomington,
Ellettsvflle, and Stinesville, to adjust working arrangements and wages from
January 12, 1917, to January 12, 1918, and this air-hammer question was up
for our consideration and was settled by agreement that we take the question
up with our international executive committees, asking that they investigate
thoroughly whether or not the use o f the air hammer is injurious to the
health o f the workman, and if found to be to either regulate its abuses to the
point where it would not be injurious or eliminate its use entirely. The club
committee took the position that it was not injurious so far as they could learn
and were more than willing that it be given a thorough investigation by the
heads o f both international organizations and settled by them as an interna­
tional question instead o f by us as a local question. This was accepted by the
committee o f workmen, and the question has been so referred, and I have no
doubt that within the next few months an exhaustive inquiry will be made and
some conclusion arrived at for the future use or elimination o f this tool.
EMPLOYER NO. 1 8 .

Regarding air tool or pneumatic hammer used in the cutting o f stone, this
Invention is a decided success if not abused by the stonecutters themselves. The
m ajority o f workmen refuse to work with mallet and chisel and use the
hammer continuously every day. It is quite possible* that this excessive use
is injurious to some workmen. The bulk o f our work is such that a man can
use and work with a mallet and chisel a good part o f the time, but the use
o f this tool is less exerting, and so the men try to use only this tool and attempt
to do all their work with it. The reform must come from within the union,
as attempts to regulate the use by employer have failed. My suggestion would
be that if the union rules demanded that all “ rough ” to be taken to a surface
o f tool chiseling be required to be done by mallet and chisel and hammer and
point, the cleaning only to be done by machine, this would eliminate all abuses
and be an advantage to the men as well as to the employer.
EMPLOYER NO. 1 9 .

[Agent’s statement.]

The representative o f this firm stated that he had been in the stone-mill
business for about 25 years, but as he had installed in his plant only two f-inch
air hammers, they having been put in only recently, he did not feel competent
to pass on the effect o f the hammer on the workman. He says, though, that if
the pneumatic hammer were withdrawn from the large cut-stone mills in this
district the mill operators would have to close out, as they could not compete
with the producer of imitation stone and substitutes.




l See Appendix B of this report.

46

PRELIMINARY INVESTIGATION BY THE BUREAU.
EMPLOYER NO. 2 0 .

As an employer o f stonecutters since 1888, during all o f this time located
here in Bedford, Ind., we believe that we are qualified from our past experience
to give the follow ing conclusions in regard to the use o f the pneumatic tool
in our locality.
During all o f this time we, o f course, have not had the pneumatic tool, but
for the past 12 or 15 years we have constantly used the pneumatic tool in the
cutting o f Bedford stone. The largest hammer that we have ever employed
has been the 1-inch hammer. W e use regularly the f-inch hammer. The 1-inch
hammer was bought for a special occasion and is very seldom used.
In all o f our experience we have never yet had a complaint from any o f our
stonecutters against the use o f the air hammer on Bedford stone; nor have
we ever had a complaint from any o f our cutters that the use o f the air ham­
mer generated a dust peculiar to the hammer that also was injurious to any
o f them.
The agitation against the use o f the air hammer by certain stonecutters and
officers is in line w ith the agitation o f the printers against the first typesetting
machines that were brought out. Their complaint against the air hammer
is, in our opinion, unjust and unfounded and is in line with their determination
to control the machine cutting tools used for the production o f cut stone. W e
believe the time w ill come when the operators who desire to control their
own business and produce stone as cheaply as possibly w ill be forced to disre­
gard the agitation against these pneumatic tools, and also the agitation in
the same line against the use o f stonecutting machinery in general.
W hile the stonecutters* association is called “ Journeymen’s Association ” o f
stonecutters the word “ journeymen,” in our estimation, does not apply to
the stonecutters o f the present day. It was a term properly applied to the stone­
cutters form erly who went from one job to another to cut the stone on the job.
The modern-day process o f cutting and preparing the stone at the site of
production has changed the character o f the stonecutter, and, instead o f being
a journeyman to-day, he is one o f our local property-owner residents. In our
own locality we count among our most stable citizens a m ajority o f the stone­
cutters cutting Bedford stone here. It is their desire, as we freely believe
and as was shown by a recent vote o f the organization here, to disregard the re­
quest to discontinue the use o f the pneumatic tool in this territory. Some o f the
stonecutters here have advised us that i f the pneumatic tool were taken from
them they would quit the business, claiming that the wielding o f a heavy ham­
mer or mallet all day is much more severe on them than the use o f the pneu­
matic tool, and also claiming that they can not possibly accomplish as much
by the use o f the hammer and mallet as they are now accomplishing by the use
o f the pneumatic tool.
For all o f these reasons w e desire to register our protest against the repre­
sentations made to your bureau, that the pneumatic tool is injurious to the
stonecutter in any way.
Believing that the cost o f production would be very materially enhanced if
the pneumatic tool were taken away from our cutters, we trust that a full
and impartial investigation o f this pneumatic tool w ill show your bureau that it
should remain in use among the stonecutters.

REPORT OF INVESTIGATION MADE IN NEW YORK.

Following is a letter from an employer, inclosing an article pub­
lished in the January, 1917, number of Stone. The article is given




ATTITUDE OF EMPLOYERS.

47

here because it describes an investigation made in New York as a re­
sult of the Indiana workmen’s complaint:
W e have your letter o f February 6 and have carefully noted contents thereof
in reference to the supposed injurious effect o f pneumatic tools on the
operators thereof.
W e do not know that we can give any conclusive evidence in this matter
further than to state that thousands o f these tools are in use throughout the
New England granite districts and elsewhere, and we have yet to hear o f the
first case where they have proved injurious to the operator for any cause
whatever, unless it might be possible that the stone dust, which the operator
inhales more or less, might be the cause o f some scattered cases o f tuberculosis,
although o f this there is no proof.
We are inclosing herewith a clipping from the publication Stone o f January,
1917, which contains an article in reference to this particular point which
you bring up, and we do not know that we could say anything regarding it
that would be any more to the point than the inform ation given in this article.
As regards the number o f strokes which the 1-inch tool makes, would advise
that as near as we can get at it, it delivers about 8,000 per minute.
AIR HAMMERS AND HAND TOOLS.1

The International Cut Stone Contractors’ and Quarrymen’s Association o f
North America has been conducting a very careful and diligent investigation
o f the charges made by the officers o f the Journeymen Stone Cutters’ Asso­
ciation that the air hammer is injurious to the health o f the users. Some o f
the results o t the inquiry are reported in the monthly leaflet issued by the
association. Instances have been found where some o f the fingers on the hand
guiding the hammer show poor circulation, and in freezing weather are more
or less sensitive to the cold, but a case o f paralysis o f the arm, or as charged,
a man being driven insane, or incapacitated in any way, has not been dis­
covered. In New York City, where the air hammer is used in the stone industry
probably more extensively than in any other city, a complaint has never been
recorded against its use, and out o f 100 stonecutters interviewed on the subject
during the past three weeks, 97 favored the air hammer. In the Brooklyn
Navy Yard the hammer is used very extensively for riveting and chipping,
and there has never been a complaint registered against its use.
The structural-iron workers use it in the erection o f the steel and structuraliron work, and the only complaint made by them was that they thought they
should receive greater compensation when using the hammer, as they ac­
complished five times the work with the air hammer as they did by hand.
At the works o f the New York Ship Building Co. at Camden, N. J., there are
in use at the present time over 1,000 air hammers, and there is no record o f
any such effect as complained o f by the stonecutters’ union, and the em­
ployees have never made complaint against its use. At these works, as also
at the Brooklyn Navy Yard, all riveting, chipping, and calking is done with
the air hammer, and the hammer used is very much heavier and more powerful
than the hammer used by stonecutters and carvers.
The investigation, as far as it has progressed, has found that where injury
to the user o f the air hammer has occurred it has been caused by ignorance
o f its use. I f there are any ill effects from the use o f the air hammer it is
caused by vibration, and the man using the hammer should be educated to hold
the hammer in such a manner as to incur as little o f the vibration as possibly




1 Published in Stone, January, 1917, p. 23,

PRELIMINARY INVESTIGATION BY THE BUREAU.

48

and he should not try, or be permitted, to do work with the air hammer for
which it is not adapted.
Mr. James B. Gillie, o f the South Dover Marble Co., a gentleman o f the widest
experience in the stone industry and one who has given a careful study to all
the problems o f the trade, writes that he has found that the use o f the pneu­
matic hammer has been of great benefit to the trade and of no injury to the
employees using the same, provided that the pneumatic hammer is used for the
purpose it was intended to be used for, viz, the finishing or lighter work done
in our trade. Personally, I have had experience with the pneumatic hammer
since it was first introduced into New York City, about the year 1901. I have
seen it used on all kinds o f stone used in the construction o f buildings. I have
personally interviewed men who have used the pneumatic hammer since it
was first introduced into New York City, and they agree with me that it has
been of great benefit to the trade and o f no injury to the employees using it.
The only complaint I have heard caused by the use o f the hammer was that
“ sometimes in the winter the hands are cold,” but when I asked the question,
“ Are the hands any colder when using the pneumatic hammer than they are
when using the mallet and chisel?” I was informed that there was practically
no difference. Like all new inventions, there are apt to be abuses caused by
the improper use o f the invention or by neglect o f other implements that were
used prior to the introduction o f this tool. The fact that the pneumatic hammer
and the necessary tools for the same are generally furnished by the employer
has given excuse to the employee to neglect the tools that he should furnish,
and it is a very frequent sight to see an employee come to work with a mallet
that has long outlived its usefulness and a few tools that are but stumps and
should be thrown into the scrap heap or made into plugs.
Another abuse o f the pneumatic hammer is allowing apprentice boys to uAe
it before they are thoroughly fam iliar with the use o f the mallet, chisel, hammer,
hammer points, and pitching tools. The consequence will be that in a very short
time new mechanics will be unable to use the tools that have always been
deemed essential to the cutting o f stone. The pneumatic hammer and tools as
an adjunct to the old time-honored tools o f the stonecutting trade are a very
decided improvement, but the fact should be brought forw ard that the old and
new must w ork togeth er; if a mechanic is thoroughly acquainted with both he
w ill be a much better employee.
I think some definite action should be taken on the question o f what tools an
employee should have when he starts to work as a stonecutter, and I have given
the matter considerable thought. I think that the smallest number that it is
possible for a competent stonecutter to work with is as follow s: One tool box
or chest, 1 square, 1 bevel, 1 scriber, 1 pair compasses, 1 2-foot rule, 1 light­
weight mallet, 1 droving mallet, 1 hammer 3$ to 4 pounds, 1 pitching tool, 18
hammer points, 8 $-inch chisels, 6 1-inch tooth chisels, 8 2$-inch tooth chisels,
8 droves, 7 splitters, 1 pneumatic hammer, 8 f-ineh chisels for pneumatic ham­
mer, 8 drafting tooth chisels for pneumatic hammer, 2 splitters for pneumatic
hammer, 2 2$-inch tooth chisels for pneumatic hammer, 2 droves for pneumatic
hammer. All o f the pneumatic tools and the pneumatic hammer to be furnished
by the employer. The balance o f the tools in the above list to be furnished by
the employee.

REPLY OF JOURNEYMEN STONE CUTTERS’ ASSOCIATION.

Dr. Joseph L. Miller, of Chicago, wrote to Dr. Emery E. Hayhurst,
of the Ohio State Board of Health, mentioning a case o f what he
diagnoses as Raynaud’s disease in one of his patients, a stonecutter,




ATTITUDE OF EMPLOYERS.

49

and inclosing a letter from Mr. Walter W. Drayer, general secretary
of the Journeymen Stone Cutters’ Association. Mr. Drayer’s letter
is of special interest in that it states the answer of the stonecutters’
organization to the findings in the New York investigation described
in the Stone article.
The correspondence is given below:
C h ic a g o , III., January 2 , 1917.
It. H a y h u r s t ,
Ohio State Board o f H ealth , Columbus, Ohio.
D e a r D r . H a y h u r s t : A few weeks ago I saw a case which interested me
very much. This gentleman had been working for a number o f years with a
power cutting device used for stonecutting purposes. He had developed a
typical Raynaud’s disease o f the hand which he had used in the work. He
told me this was very common among these workers, and he gave me an address
to write to where I could get more accurate information. I am inclosing you the
letter received from this source.
It seems to me this is a most interesting problem as well as one o f great
importance, because the man I saw, I suspect, wT be permanently disabled.
ill
I thought perhaps you might be interested in this question. Perhaps you are
already fam iliar with it and might be able to put some one on it to make
further investigation.
I wish, after reading over the letter, you would return it to me, as I wish to
keep it on file.
Yours, sincerely,
J o s e p h L. M il l e r .

Dr.

E mery

C h ic a g o ,

Mr.

W

alter

III., Decem ber 16, 1916.

W . D rayer,

Indianapolis , Ind.
: I recently examined a stonecutter who worked with a power cut­
ting device; he showed peculiar disturbance o f the circulation o f the fingers.
This subject interests me, and he told me that I could probably obtain some
information from you regarding the frequency o f this condition, etc. Could
you furnish me with any reference to the literature on this subject?
Sincerely,
J o s e p h L. M il l e r .
D e a r S ir

I n d i a n a p o l i s , I n d .,

Decem ber 19, 1916.

D r . J o se p h L . M il l e r ,

Chicago, III.
: Replying to your favor o f the 16th instant, w ill say that the p o w e r
cutting device used for stonecutting purposes to which you refer is the pneu­
matic tool or air hammer. I regret that I do not have any literature bearing
upon the detrimental effects suffered by the mechanic who uses this tool fo r
cutting stone. I- inclose cut o f one o f these tools which w ill give you an idea
o f its size, etc. It is operated with compressed air under a pressure o f 80 to
100 pounds.
This tool is used in the place o f the stonecutter’s mallet and hammer, the
chisel fitting into the hammer being handled in the same manner as it must be
handled by the mechanic when cutting the stone with a mallet and chisel.
D e a r S ir

18476°— 18— Bull. 236-------4




50

PRELIMINARY INVESTIGATION BY THE BUREAU.

During the past two or three years this hammer has been universally in­
stalled in what is known as the Indiana oolitic stone belt, comprising the cities
o f Bedford, Bloomington, Ellettsville, and Stinesville, Ind., where are located
many o f the largest cut-stone plants in the country.
Our experience with the tool is that anyone who uses it for stonecutting
purposes suffers a partial paralysis o f the circulation, first in the left hand, or
the hand that holds the chisel, and in a number of instances in both hands.
Some men are affected in two or three months, while others do not notice the
effects for a longer length o f time. The constant vibration connected with the
use o f this tool in the manner in which the mechanic is compelled to use it for
cutting stone produces a feeling o f numbness, perhaps better described by illus­
trating or comparing it to the feeling one has when his foot or hand goes to
sleep. W hile the operators to whom we have complained o f the detrimental
effects o f the use o f this tool deny that it injures the user, yet one has only
to go into the oolitic stone belt o f Indiana at any time when the thermom­
eter is registering 30° above or lower and he can pick out a hundred o f the
men who use this tool, and no further investigation need be made to prove
that this tool w ill physically ruin the man who uses it. In many o f these shops
in the Indiana district the stonecutter is compelled to use this tool eight hours
a day, with all the power that lays behind him, and if he complains that the
hammer is ruining his physical well-being and attempts to cut stone with the
mallet and chisel, even though he might be able with these tools to produce the
same amount o f work, he is promptly advised that his services are no longer
required. From this you w ill note that even though the mechanic, realizing
that the constant use o f this tool is ruining his physical well-being, endeavors
to protect his health by using the tool but intermittently or for a portion o f the
day only, he is not permitted to do so by the employer, who seems to have no
regard even for humanitarian measures.
This question has been a live issue with our organization for the past three
or four years, and we find it difficult to obtain any literature on the matter for
the reason that air tools are used in other trades where they are not handled
in the same manner and where they do not produce these detrimental physical
effects that they do when used for stonecutting. Our members, too, fearing
that should they come out and condemn the hammer as individuals, will be
discriminated against by the employer, w ill not individually submit complaints
as to the injuries they are suffering from this tool.
I can perhaps best describe the detrimental effects o f the use o f this tool by
my own personal experience with it. Some six or seven years ago I used this
tool for carving and other light work upon a Vermont marble job, which marble
is considerably harder than the stone used in the Indiana belt (w e find that the
harder the stone the easier it is on the mechanic, and that one does not feel the
effects o f using the tool so rapidly on hard stone as he does on soft stone), and
although I used the tool but a matter o f six or eight months, my hands to-day,
especially on a morning when the thermometer is around freezing, are numb
and have the appearance that life has left the hand entirely. When I noticed
the effect o f the use o f this tool upon my hands I consulted my fam ily p h y s i­
cian, a most capable and efficient surgeon, and he advised me that the constant
vibration o f this tool had brought about a paralysis o f the circulation leading
down into my hand and fingers. This paralysis o f the circulation is not tem­
porary or suffered only during the time the mechanic uses the tool, as is
proven by the fact that though I have not touched one o f these infernal tools
fo r the past fou r or five years, I am still troubled with the numbness and lack
o f circulation in my left hand, which is not only annoying, but proves a great
hindrance in the perform ance o f my present duties. My left hand and fingers




ATTITUDE OF EMPLOYERS.

51

are in this condition most every morning when I reach the office, and many
times it takes from one to two hours to get the circulation again started and
the hand and fingers again normal.
We have complained frequently, when in conference with the employers’
association, o f the detrimental effect suffered by our members compelled to
use this tool, and have sought to have them investigate the matter and in
some way restrict the use o f this tool so as to partially eliminate its injurious
effect, and they did agree to make an investigation and consider some method
in this direction.
I may say that we recently learned that they instituted an investigation in
New York City, first among the stone yards where the tool is used in a half
humanitarian way, in no comparison to the manner in which the men in the
Indiana stone belt are compelled to use it and where the injurious effects are
most noticed, and they proudly boast that they found no serious results in this
investigation from the use o f this tool. Not only did they investigate the tool
in the stone shops in New York, where the employers take some precaution
looking toward eliminating the injurious effects o f the use o f this tool, but
they extended their investigation to the Brooklyn Navy Yard, the New York
Shipbuilding Co.’s works, and on structural-steel work. As I have stated above,
the tool when used by mechanics in these callings is used in a far different
manner than when it is used for stone cuttings; in fact, the operator handles the
hammer with both hands, does not hold a chisel inserted in the hammer as
does the stonecutter, and the tool does not produce the injurious effects to
anywhere near the extent it does in cutting stone. I f the employers’ associa­
tion were in earnest in their investigation and would be fair, they would have
started their initial investigation in the Indiana stone belt, and we have no
other evidence to offer these but to produce any number o f mechanics up
to 150 or more and submit proof positive that this tool does ruin the physical
well-being o f the man who uses it.
I am pleased to know that you are interested in this matter, and should you
wish to make further investigation, I would be only too pleased to cooperate
with you. It is a matter o f but a few months when an investigation w ill be
made by some one regarding the effects o f the use o f this tool, as bills w ill go
before the various State legislatures in the very near future seeking its com­
plete abolishment as a stonecutting tool.
Trusting I have given you a clear idea o f the evil results from the use o f
this tool, and assuring you that I shall be pleased to answer any further
questions upon the subject, I am,
Yours, very truly,
W alter W . D r ayer ,
General Secretary.
C h ic a g o ,

Mr.

W

alter

W.

III., January 2, 1917.

D rayer,

Indianapolis , Ind.
I was very much interested, indeed, in your letter. It
seems to me this is a very serious problem and should be investigated. I have
taken this matter up with a friend o f mine, who is interested in industrial
medicine, in the hopes that he might have some one to put on the problem.
The man I saw here before writing you certainly had a very serious disa­
bility, which I am rather fearful w ill be permanent. I f I hear anything
further regarding this matter from the doctor to whom I have written I will
let you know. Meanwhile let me thank you again for the letter giving a full
account o f this condition.
Yours, sincerely,
J. M i l l e b .
D ear M r. D r a y e r :







PART II.— RESULTS OF OFFICIAL INVESTIGATIONS BY PHYSICIANS.
REPORTS OP PHYSICIANS FOR THE BUREAU OF LABOR
STATISTICS.
A STUDY OF SPASTIC ANEMIA IN THE HANDS OF STONECUTTERS.
BY ALICE H AM ILT O N , M . D.

In March, 1917, Dr. Joseph L. Miller, of Chicago, called my
attention1 to an unusual occupational disease in a stonecutter from
the Indiana limestone region, who was accustomed to use the air
hammer in his work. The man complained of attacks of numbness
and blanching in certain fingers, coming on suddenly under the
influence o f cold and then disappearing again. When he called on
Dr. Miller for advice he had no visible signs of the trouble, but
from the description he gave Dr. Miller believed it to be a form of
Raynaud’s disease and he thought that since there were said to be
many similar cases in the limestone region it was a condition that
1 T h e letter is printed in fu ll below :
M a r c h 19, 1 9 1 7 .
Dr. A l ic e H a m i l t o n ,

Chicago, III.
a m i l t o n : I thou ght you m igh t be interested to know the history o f this
M r. M cB raird y, w hom I saw here a t the office on Novem ber 18.
H e is 32 years o f age,
o f good fa m ily history, sm okes about 10 cigars d aily, is a very m oderate user o f alcohol,
has worked nine years holding th is air-driven drill, and he has held it in his le ft hand.
T w o or m ore years ago he first noticed th a t the little finger and the ad jacen t one on this
hand becam e pale and numb w hen using the in stru m en t in cold w eather.
T h is trouble
has grad u ally increased un til at the present tim e in cold w eather, w hen he is not w ork­
ing, these fingers on the le ft hand become numb and turn w hite ; in other w ords, present
all the sym pto m s o f R ay n a u d ’s.
In sum m er he has no trouble, even w hen w orking.
He
stated th a t he had worked at this but five years before the trouble began.
H e stated to
me also th a t som e o f the men who worked w ith this instrum en t developed paresis o f the
entire arm , and he com plained some of his arm being pain fu l and som ew hat w eak.
P h ysical exam in ation , includin g the blood pressure, showed noth in g abnorm al.
I
thou ght you m ight be interested in this brief report.
I
believe it w ould be very interestin g in these cases to note w hether there is any
difference in the appearance o f this trouble in a m an w ho is a heavy user o f tobacco,
inasm u ch as th a t has a lw ays been considered a possible fa cto r in R ayn a u d ’s, and also to
note w liat fingers are first involved, and to see w hether it is associated w ith any m arked
thickening of the radial arteries.
Please excuse me for m akin g these suggestions, but the problem appeals to me as such
an in terestin g one th a t I have given it quite a little thou ght.
I f, after you get started
in your work down there and get the p atien ts lined up, I can be o f any assistance I sh a ll
be glad to run down to In d ian ap o lis for a day so as to go over the clicinai side o f this
condition w ith you.
W ith kindest regards, I am ,
Y ours, sincerely,
J . L. M il le r .

D ear D r . H




53

54

REPORTS OF PHYSICIANS REPRESENTING THE BUREAU.

merited close study. The Bureau of Labor Statistics had made a
preliminary inquiry into the matter and found that the limestone
cutters do suffer from “ dead fingers.” Later it was reported that
granite and marble cutters do not suffer from this affection. This
was denied by the men. The bureau authorized me to visit the lime­
stone belt of Indiana, the granite-cutting centers in Quincy, Mass.,
and Barre, Vt., the marble shops of Proctor, Yt., Long Island City,
and Baltimore, and the sandstone mills of northern Ohio.
Since the condition in the men’s hands which was the object of
this inquiry comes on under the influence of cold, I made my visits
during January, February, and March of 1918 on days when the
temperature was between 14° F. and 34° F. I discovered a very
clearly defined localized anemia of certain fingers which is undoubt­
edly associated with the use of the air hammer and which, while it
lasts, makes the fingers numb and clumsy %
causing the workman more
or less discomfort and sometimes hampering his work.
The pneumatic hammer consists of a handle containing the ham­
mer, which is driven by compressed air and is said to deliver from
3,000 to 3,500 strokes a minute. The amount of air delivered through
a hammer can be controlled by a valve in the pipe conveying the air,
and the air escapes through an exhaust opening in the handle itself.
This handle is held in the right hand in various ways, sometimes with
the palm of the hand down and all the fingers grasping the handle
equally, sometimes with the palm up and the grasp exerted chiefly by
the thumb, index, and middle fingers; it may also be held between the
thumb, middle, and index fingers, very much as a pen is held. Ham­
mers are of various sizes; there is the small half-inch, the medium
five-eighths or three-fourths inch, and the large 1-inch hammer. The
tool (the chisel) is held by the left hand against the hammer, with
the cutting edge pressed against the stone. Italian workmen usually
slip the tool between the little and ring fingers, so that it rests against
the side of the little finger, where a large callus develops. Other
workmen grasp the tool with all four fingers. In either case the little
and ring fingers, being nearest the cutting end of the tool, are pressed
most closely against it in order to guide it.
The conditions under which stone is cut differ somewhat for the
four kinds of stone. In the limestone region of Indiana and in the
sandstone region of Ohio there are large mills heated somewhat in
winter, so that the temperature is perhaps 10 or, rarely, 20 degrees
higher indoors than outside. This would mean that when the ther­
mometer stands at 15°* F. the working atmosphere will be at about
freezing point or perhaps as high as 38° F. In Quincy and in Barre,
granite is cut in sheds, which in the former town are wide open, but
in Barre are inclosed and sometimes slightly warmed. They are,
however, colder than the western mills and in very cold weather work




SPASTIC ANEM IA IN THE HANDS OF STONECUTTERS.

55

has to be suspended. The marble shops are inclosed and usually bet­
ter heated than any of the other stonecutting shops I visited. I did
not see a place in any mill or shed where a man could warm his hands
conveniently.
The air hammer is used in cutting all four kinds of stone, but not
to 'the same extent in all. Limestone cutters use it almost all the
time. When one enters a mill in the limestone region the stonecutters,
with a very few exceptions, are all seen to be using the air hammer.
It is rare to see more than two or three men wielding the mallet,
unless they are apprentices who are required to use it.
In cutting limestone the air hammer can be used both for shaping
the block of stone, a process known as roughing out, and for cleaning
up or making a smooth surface. Many men say that the roughing
out should really be done with the mallet, but in practice the air ham­
mer is used. Limestone cutters use all sizes of tools; the carvers use
the smaller ones chiefly or entirely. Marble cutters come next in their
use of the air hammer. They work more with the mallet than do the
limestone men, but the greater part of their work is with the pneu­
matic tool and usually the smaller sizes, the half or three-fourths
inch tool.
Granite cutters can not use this tool for shaping the block. That
must be done by hand, because the stone is so hard. For dressing the
surface they use two machines, a large heavy surfacer with a big
handle, which is grasped in both hands and held upright, the tool
pressing on the surface of the stone; and a smaller “ bull-set” or
“ four-point,” which also has a fairly large handle and a short tool,
and which is also held perpendicularly in both hands and pressed
against the surface of the stone. The tool in both these machines is
held in place by the hammer and stone, never grasped or guided by
the left hand. For lettering and carving, however, the granite worker
uses the same sort of air hammer as is found in marble and limestone
mills, and there are granite workers who use it all day long, but these
are the exception. As a rule the men I questioned in the granite
sheds use it only four, five, or six hours a day.
In sandstone the air hammer seems to be of little use. A mill I
visited near Amherst, Ohio, had five air hammers for 30 men, and
that number was quite sufficient. Sandstone does not require much
tooling. It is used chiefly for paving stone, curbstones, grindstones,
and exterior building stone. Much of the tooling required is done
by hand, for the nature of the stone makes work with the air ham­
mer difficult or impossible. I questioned 15 sandstone cutters and
was told by 6 that they had never used the air hammer at all. Two
had formerly used it in marblework, but not in sandstone, and 7
used it now and then for sandstone, but hardly more than half
an hour during the day.




56

REPORTS OF PHYSICIANS REPRESENTING THE BUREAU.
DESCRIPTION OF STONECUTTERS’ W H ITE FINGERS.

The trouble which I found among the limestone cutters, granite
workers, and marble carvers is not Raynaud’s disease. It is a spastic1
anemia, affecting the arterioles of the fingers and hands—it comes on
in sudden and recurring attacks under the stimulus of cold as does
Raynaud’s syncope,2 and the pallor is much more pronounced, but it
is not succeeded by the stage of extreme asphyxia so characteristic
of Raynaud’s—it is not symmetrical,-even when in both hands, and
it does not result in the wasting and death of tissue which accom­
pany Raynaud’s. I did not see any marked swelling or excessive
congestion, or severe pain. Nor did I see hands with thickened
fingers or deformed nails; on the contrary these stonecutters had
well-formed and well-preserved nails such as one seldom sees in
manual workers. No history was given me of necrosis3 or blisters
or ulcers or desquamating skin,4 and the pain complained of was
nothing like so severe as that often experienced in Raynaud’s disease.
As to the distribution of the vascular spasm, this is not capricious
as in Raynaud’s but apparently determined by definite causes. It is
not really symmetrical. The left hand is usually the only one
affected, and when the right hand suffers the fingers involved are not
the ones corresponding to those involved on the left hand.
The examination which I was able to give the men in the absence
of all laboratory equipment established the fact of a spastic anemia
undoubtedly of occupational origin and accompanied by certain more
or less definite sensory changes which sometimes persist to a lesser
extent between the attacks. I could not determine how great the
latter are nor whether there is any real impairment of the function
of the affected hand. That part of the investigation was undertaken
in Chicago by Dr. Thor Rothstein, whose report follows mine.
A description of one or two of the more marked cases will show
just what this condition is. The first is a limestone cutter whom I
saw early in the morning when the temperature was about 14° F.
He had been out of doors for over half an hour and in order to be
able to show me his hands in a typical condition he had refrained
from rubbing them violently and swinging his arms about, as he
w^ould ordinarily do to restore the circulation. The discomfort, how­
ever, had grown so intense in his fingers that he could not bear it
any longer and almost at once after I arrived he began rubbing and
kneading and shaking his hands. The four fingers of his left hand
were a dead, greenish white and were shrunken, quite like the
hand of a corpse. The whiteness involved all the little finger to the




1 Characterized by spasm s.
2 Sudden pallor and in sen sib ility.
8 D eath o f cells surrounded by liv in g tissu es.
‘ •Falling off o f the cuticle in scales.

SPASTIC ANEM IA IN THE HANDS OF STONECUTTERS.

57

knuckle, but in the other fingers it stopped midway between knuckle
and second joint. As he rubbed his hand the contrast between
fingers and hand increased and at one stage it was very striking,
the crimson and slightly swollen hand meeting the white shrunken
fingers abruptly, without any intermediate zone. On the palmar
side the condition was not so distinct, for the skin was too thick and
calloused to allow the color to show well.
The right hand was much less affected, the little finger escaped
altogether, the three others were white, but not dead white, as far as
the second joints, and there was a ring o f white around the second
phalanx of the thumb. After vigorous massage and beating of his
arms back and forth over his chest, the blood gradually filled the
fingers and the appearance then was fairly normal, showing only a
moderately purplish red color, and no swelling.
This man is 89 years old and has cut stone for 22 years. While
using the ordinary tools of his trade he had no trouble of this kind.
Nine years ago he began to work with the air hammer and during
the second winter after that he noticed that the ring finger of the
left hand had begun to “ go white.” Gradually the little finger be­
came involved, then the others, and, to a less extent, the fingers of
the right hand. The trouble has progressed through the years and
is still increasing. There is a good deal of pain in the fingers, espe­
cially on a cold morning. As long as the dead-white condition lasts
there is no real pain, but discomfort enough to make him stop work
and get the blood back into his fingers, for the stroke of the hammer
on the tool he holds in the left hand is peculiarly intolerable when
the fingers are white. As the blood comes back there is some sharp
pain but it does not last. At no time, however, does the left hand
feel quite natural, he is always conscious of i t ; indeed his whole left
side, including the foot, feels differently from the right. I f he holds
his hands, up for a few minutes they grow numb and this is annoy­
ing when he tries to read a newspaper and must continually put it
down to coax the blood back into his hands. He has lost sensitive­
ness in the fingers, so that he call not put his left hand in his pocket
and pick out a coin by the touch; he must look at it to see if it is a
dime or a nickel. He is clumsy in the morning when buttoning his
clothes and lacing his boots. I f he works all day with the hammer
he has a restless, disturbed night.
The second man is a marble cutter who has followed his trade for
20 years and has had trouble with his fingers from the fifth year on.
He uses the small tool almost entirely. The four fingers of the lett
hand were white, the little finger over the whole extent, the next two
over the two distal joints, the index over the first joint. On tho
right hand the tips of all four fingers were white and there were
irregular streaks of white along the index and middle fingers. This




58

REPORTS OP PHYSICIANS REPRESENTING THE BUREAU.

man complained of the pain in his fingers both when they were white
and when the blood first began to come back, but his chief complaint
was of nervousness from the vibration of the hammer; he said it up­
set him, made him 4 as nervous as a kitten,” spoiled his sleep, made
4
him irritable. Though he is troubled chiefly in winter, he can not
put his hands in cold water in summer without making his fingers
“ go white.” In winter, if he is working indoors he is not really
hampered by the numbness in his fingers, but he can not do any
fine work out of doors if the weather is at all cold, for the numbness
makes his fingers clumsy.
The third is a granite cutter who has used the air hammer for 18
years and who began to feel the effects in his fingers after two years.
Now his left hand shows all of the little, ring, and middle fingers in­
volved and all but one-third of the index finger. On the right
hand most of the index and middle fingers and the tips of the ring
and little fingers are blanched, but not so strikingly so as the fingers
of the left hand. He is “ bothered ” a good deal by the numbness in
winter, and it comes on whenever he handles a cold tool, after which
he finds it hard to do any fine work till he has managed to get the
circulation started again.
There is no need to multiply these descriptions. With a few
variations the men from whom full histories could be obtained told
much the same tale, though the majority had not suffered as much
discomfort as had these men. These stonecutters are exceptionally
good material for such a study, for they are intelligent men, usually
of good education and able to note and describe their symptoms
clearly. There is among some of them a tendency to dwell perhaps
too much on the nervous disorders which they believe are caused by
the tiring vibrations of the hammer, and which give them a good
deal o f worry. O f nearly all of the men this is not true. Many
o f them have no complaint at all, except of the actual condition
in the hands, but others suffer from more or less distressing symp­
toms which they think are caused by the vibrating hammer. The
most common symptom is covered by that vague term “ nervousness.”
They say that they feel jumpy and irritable, upset by a slamming
door, and unable to settle down after a full day’s work with the
tool. Their sleep is disturbed and restless, and they have buzzing
or ringing in the ears. The numbness in the hands is inconvenient,
for they can not hold a newspaper or a book for any length of time
without being forced to put it down and rub and knead their hands.
Sometimes they have to sleep with the left arm hanging down from
the bed or the numbness will waken them, and then they must get up
and swing the arms about or bathe the hands in hot water. Some
of them are not troubled at all in summer, others get numb fingers
on chilly days or if they put their hands in cold water. A few men




SPASTIC ANEM IA IN THE HANDS OP STONECUTTERS.

59

complain of trouble with the left foot, which is colder than the
right.
The local changes are surprisingly similar in all these cases. There
is no capricious localization of the anemia. Invariably the little
finger of the left hand is affected, never, so far as I saw, the left
thumb, though a few men said they believed it did sometimes “ go
dead.” I f one finger on the left hand escapes, it is the index finger.
The most usual distribution is over the little and ring fingers, part
of the middle finger, and somewhat less of the index on the left
hand, so that the line between the pale and red portions runs diago­
nally from the knuckle of the little finger to the first joint of the
index. Sometimes there is a spot of white in the center of the left
palm. The right often escapes entirely, so far as evident signs go,
and when affected it is less strikingly so than the left, and the anemia
is less uniform in its distribution. The right thumb is sometimes
involved, the index finger often, but the other fingers are hardly ever
pale except at the tips.
There were two men who surprised me by displaying left hands
with anemic finger tips and right hands with anemia of all four
fingers, but both proved to be left-handed and they use their hands ac­
cordingly, holding the tool in the right hand and the hammer in the left.
Many men told me that the white area on their hands sometimes
extended as far as the wrists on the ulnar side, but I never saw it
reach even quite to the knuckles.
Usually the men say that the blanching of the fingers is most
marked early in the morning and passes away more or less while
they are at work with the hammer, returning in the afternoon when
work is over. I examined a little over 100 soft-stone, marble, and
granite cutters at work and could actually see the pale fingers in
only 22, but among 23 men I saw away from the plants 16 showed
the condition quite strikingly after they had exposed their hands to
the cold for a few minutes. Among those who came to see me at the
hotel there were some whose hands grew warm fairly quickly and
appeared quite normal after they had been in the room a short time,
but in other cases a decided difference persisted in the color and tem­
perature of some of the fingers of the left hand as compared with
other parts of that hand and with the right hand. Several men told
me that there was always some difference in the feeling of the two
hands. Men who had had attacks of white fingers could always
bring the condition on by washing their hands in cold water or
going out of doors for a while.
In several cases there were no local patches of anemia but the left
hand looked smaller as well as paler than the right. In fact one
marble worker showed a very striking difference in the size o f the
two hands. Another marble worker showed the reverse condition, a




60

REPORTS OF PHYSICIANS REPRESENTING THE BUREAU.

paler and smaller right hand, but this man proved to be left-handed.
I also heard from two former granite cutters, now employers, a his­
tory o f wasting of the muscles of the hand from the use of the air
hammer. One of these men used the air hammer for 20 years and.
after the first 2 years the fingers on the left hand began to get white,
but later on he noticed that the interosseous1 muscles of this hand
were wasting and deep hollows appeared between the thumb and
index finger and between that finger and the next. He gave up the
work and the hand gradually went back to its normal state. The
second man’s history was similar, only that he had the wasting in his
right hand, being left-handed and hol'ding the tool in his right hand.
He, too, recovered entirely after leaving the work in the shed.
I tried to discover whether this condition persists even after a
man has left the trade of stonecutting, whether in cold weather he
still has attacks of blanched, numb fingers. There are a few men
still working at the trade who say that it passes away gradually;
that they used to be much more troubled by it than they are now.
On the other hand, I found several men who are no longer cutting
stone, who gave up the trade several years ago, and yet still have
numb, white fingers at times in winter or if they try to work with
cold metal. I will give the essential points in the histories of eight
such men.
The first was a granite cutter for 20 years, but left the trade eight
years ago. Three fingers of his left hand still get blanched and
numb in winter. The second, also a granite worker, stopped work
eight years ago but still has the condition at times in the fingers of
the right hand (he is left-handed). The third left granite cutting 12
years ago, after four fingers of the left hand had become affected,
and those fingers grow white now in winter. The fourth, also a
granite worker, came into the office of the union while I was there,
and I noticed at once the dead-white, shrunken condition of his left
hand, very characteristic and marked. He told me that he was no
longer cutting granite; had not done it for four years, yet the con­
dition persists. Tw'o limestone cutters left the trade six and eight
years ago, but both have numb, white fingers on cold mornings.
Two marble workers are now cutting sandstone after some years
in the marble trade, during which time they suffered from white
fingers, and though it is now 10 years and more since they ceased to
use the air hammer, they still have traces of the trouble.
It is very important to know whether this condition of the hands
affects the men’s skill or strength, whether it lessens their earning
capacity in case they wish to take up other work than stonecutting.
I can not speak with any positiveness as to this, but the tests made by
Dr. Rothstein throw some light on the question. Few of the men




1 Between the bones.

SPASTIC ANEM IA IN THE HANDS OP STONECUTTERS.

61

whom I saw complained of loss of sensation in the fingers great
enough to hamper them, except when the fingers were actually
numb. The majority noticed no change at all in the intervals be­
tween attacks of numbness. But, of course, an occupation which
had to be carried on in the cold might be impossible just because
the numbness would inevitably come on. For instance, one man had
tried to work in an automobile repair shop, and found that on a cold
day he could not pick up or hold small screws or small machine parts
with his left hand. Another had taken up work which involved
handling a crowbar sometimes, and when he did this in winter his
left hand would grow numb and so clumsy that he could not use it
with skill. The only men who complained of clumsiness in their
own work from numb fingers were marble workers who require a
high degree of skill, and who find that cold weather often makes it
impossible for them to do their best work, especially if they are out
of doors.
To understand why the left hand is most affected by the air
hammer, one has only to experiment with it. I tested several ham­
mers, from the small light one used by the carvers to the heavy 1-inch
hammer. At first the vibration in both hands is so severe to an un­
accustomed person that it is impossible to distinguish much between
them, but presently one finds that it is possible to hold the hammer
in the right hand without grasping it tightly, while the tool held in
the left hand must be clung to with much more force or the blows
of the hammer will drive it from the hand. This tool receives the
T
direct blows of the hammer, delivered, I was told, over 3,000 times
a minute. The handle of the hammer is large and easy to hold,
while the tool is small and the fingers are usually cramped about
it, which of course drives the blood out of the fingers of the left hand.
It is this hand also that does the cutting, guiding the tool along the
surface of the stone. The little and ring fingers are pressed against
the tool especially close to do this guiding. It did not take me
long to become convinced that the effect of the air hamiper is
greater on the left hand than on the right. The effort expended is
greater, the muscles are more cramped, and the vibrations are more
violent.
This test of the air hammer explains also why the right hand is
less uniformly affected than the left, some men having no ^trouble
at all with it. The work done by the right hand admits of more
variety than that done-by the left. The handle may be held in sev­
eral different ways and the strength of the grip relaxed sometimes.
Some men find it possible to relieve the right hand by winding a
pad or slipping a piece of hose around the handle, deadening the
vibration and protecting the hand from the cold steel. It is true
that the right hand does sometimes get the force of the cold air from




62

REPORTS OF PHYSICIANS REPRESENTING THE BUREAU.

the exhaust which issues in a sharp blast, freezing cold, from an
opening in the handle of the hammer. Some men get this blast on
the right thumb or index finger, because in doing certain kinds of
work they like to vary the force of the blows from minute to minute,
and they can do this by controlling the exhaust with the thumb or
finger. The control is usually exerted through a valve lower dowT
n
in the pipe, which is really the proper way to manage it. However,
even when a man does control the exhaust with his thumb or finger,
he does not have as much anemia in the right hand as in the left.
PREVALENCE

OF W H ITE

FINGERS AMONG STONECUTTERS.

Spastic anemia of the fingers is found to some extent among all the
four classes of stone workers, with the exception of those sandstone
cutters who have never worked in any other sort of stone.
The first region I visited was the limestone belt o f Indiana,—the
towns of Bloomington and Bedford. There I was able to examine
21 men who came to the hotel to see me and 17 who were working
in the mills at the time I went through them. In Quincy and Barre
I saw 50 granite cutters, all but 3 of them at work in the sheds. I
examined 78 marble cutters at their work in Proctor, Long Island
City, and Baltimore, and 15 sandstone cutters in a mill near Am­
herst, Ohio. In all 181 stonecutters and carvers were examined.
Among sandstone cutters spastic anemia of the fingers is not
found. I visited a mill in which 15 men were at work at the time
and the only ones who had ev$r had dead fingers were three former
marble cutters. They had used the air hammer in marble work
and their fingers had shown the effects, but in working with
sandstone they had used it so little that the trouble was passing
away. The other 12 either used it not at all or very little. This is
the rule in sandstone work and the result is that dead fingers are not
found among the men in this branch of the stone trade. I found also
three marble workers and one granite worker who had not used the
air halnmer and who also had had no trouble with their fingers.
In limestone, granite, and marble work, the condition is so com­
mon that any inquiry about it meets with instant response. One
does not have to stop to explain. In Quincy and in Barre many of
the grggiite workers are Italians who speak little English, but as
soon as they understood my question they would hold up in answer
one, two, three or four fingers of the left hand, but often would shake
the head when I then pointed to the right hand. It had been charged
that the agitation about this condition among the Indiana limestone
men had been influenced by the fact that at the time there was a
controversy between the employers and the union concerning the
use of the air hammer, but there was no controversy in the granite or




SPASTIC ANEM IA IN THE HANDS' OF STONECUTTERS.

63

marble shops, and yet the testimony given by the men in these two
fields was much the same as that given by the limestone men.
On the whole the condition set up in the men’s fingers by the use of
the air hammer does not seem to be so pronounced among the ma­
jority of marble and granite workers as among the limestone cutters.
This is true both as regards severity and as regards the proportion
of men affected. Among the 38 limestone cutters and carvers there
were only 4 who had never had white fingers. About as small a
proportion of granite workers had escaped—only 7 out of 50—but
the effect was much slower in onset among these men than among
limestone workers, most of them having worked 5 years or more
before their fingers began to show the effects. This is probably
attributable to the fact that granite workers, as I said above, do not
usually work all day long with the air hammer; they use the mallet
more than do the limestone men. A much larger proportion of
marble workers were free from anemia of the fingers—34 out of 78.
There were also few men in this last group who complained of the
numbness or pain in their fingers or said it made them clumsy or
that the vibrations of the machine made them nervous.
I attribute this difference partly to the smaller tool used by most
of the marble workers, partly to the fact that marble shops are better
heated than the mills and sheds in which the other kinds of stone
are cut, and perhaps also to a greater skill in handling the tool, the
carver apparently holding it more easily and lightly than the cutter.
However, there is another difference which must also be taken into
account. Limestone and granite workers belong to a strong union,
while all the marble shops I visited are nonunion, and though I
hardly like to say that that fact kept the marble workers from
answering my questions as freely as did the union men, still it must
be admitted that a visit made to a nonunion shop under the guidance
of the foreman or manager is not the best way to elicit full histories
o f occupational disease.
The slighter effect of the small hammer used by carvers was illus­
trated in one marble shop where among 12 men who used it only 1
had had white-fingers, while among 18 who used the large hammer
12 had had this trouble.
The men who show no effects from the air hammer usually attrib­
ute their immunity to a more skillful use of the tool. They say
that they hold the chisel lightly and never cramp their fingers around
it, or they wind thick cotton or wool around the left hand to protect
it from the cold. However, I have seen blanched fingers in many
men who wore thick gloves on the left hand. One marble worker
told me that the condition of the machine made a great deal of
difference. He always had trouble with his hands if he worked in
a shop where they used old hammers and did not keep them in order,




64

REPORTS OF PHYSICIANS REPRESENTING THE BUREAU.

for these grow loose and the tool slips unless it is held tightly, and
the vibration is worse. With a new small tool he has no trouble at
all. Certainly some men can use the air hammer for long periods
and show no effect from it. I saw a limestone carver who had
worked with it 23 years, a granite cutter who had done so all day
long for 18 years, and two marble cutters who had used it quite
steadily for 15 years, and none of them had any numbness of the
fingers.
.

CAUSE OF SPASTIC ANEMIA OF THE FINGERS.

There can be no reasonable doubt that this spastic anemia of the
stonecutters’ fingers is caused by the use of the air hammer. The
more continuously it is used, the greater the number of men affected
by numb fingers and the more pronounced their symptoms. The
greatest complaint is heard from the limestone and marble cutters
who use the air hammer for the greater part of their working time.
Granite workers have numb fingers also but they do not seem to
experience as much discomfort as do the men in the other two
branches, and granit.e workers do not use the hammer much more
than half their time. Sandstone cutters use it little or not at all and
this is the one stone trade in which numb fingers are almost un­
known. One man only was found in any of the stone trades who had
this condition of the fingers and had not used the air hammer, and
he had only the tip of his little finger affected.
It is, o f course, possible that the same condition might be brought
about by the use of the mallet and chisel, for the factors that
operate in air-hammer work are present to some degree in work
with the mallet— a cold tool grasped tightly by the left hand and
vibrating from the blows of the mallet. Only the condition would
certainly come on much more slowly and probably never attain the
same degree, because handwork can never be as continuous as ma­
chine work, it must be interrupted from minute to minute; indeed
it is probable that between each two blows of the mallet the hand
holding the chisel relaxes slightly. In work with the air hammer
the fingers of the left hand grasp the chisel so tightly and so long
that I have seen men obliged to bend them back with the help of
the right hand after the tool was laid down, they had grown so stiff.
It is certainly true that while stonecutters may have had “ dead
fingers” before the air hammer was introduced, the condition was
not at all common or striking.
There seem to be three factors in the production of this vascular
spasm— cold, cramping of the fingers, and the vibration of the
hammer and tool. As we have seen, cold acts as the exciting cause
of an attack, but it alone can not cause the trouble. Frostbite is a
totally different condition. The clutch of the fingers around the tool
drives the blood out of the blood vessels and anything that makes




SPASTIC AN EM IA IN THE HANDS OF STONECUTTERS.

65

it necessary to hold the chisel especially tight seems to add to the
numbness and deadness of the fingers. The large tool has to be
held very tightly and marble workers find it more trying than the
small tool. Old, loose hammers give more trouble than new, tight
ones that hold the tool better. The difference in its effect on different
individuals is also usually explained by the different way they hold
the tool, for if it is held loosely the man may have no trouble at all
with his fingers.
It is hard to say how much the vibration has to do with it. Men
who suffer through nervousness which they attribute to the use o f
the air hammer think it is the vibration that has caused it, but as
to the effect on the hands, it seems impossible to separate the part
played by- vibration from the part played by the strong muscular
contraction. The tool that vibrates most has to be held tightest, so
the two factors act together. Dr. Rothstein regards the vibration as
probably the important factor in the causation of the vasomotor and
sensory disturbances he found in the men examined.
Because o f the fact that the use of tobacco sometimes causes a
spastic anemia o f a distinctly localized character, Dr. Miller in his
letter to me about the patient whom he had seen suggested that this
point be inquired into when histories of the men were taken. I
could not establish any connection between the use of tobacco,
smoking or chewing, and the appearance o f dead fingers. The men
are not, on the whole, heavy users o f tobacco, for smoking at work
is generally forbidden and chewing during work is not common. I
could not find any indication that tobacco was ever the exciting cause
o f an attack of white fingers.
German and Austrian stonecutters in the limestone region say
that the use o f the air hammer in those two countries has been for­
bidden by law because it was discovered that the men who had used
it could not handle their rifles properly when doing their military
service. There is nothing in German factory inspection reports to
confirm this statement. The last reports accessible to us are for the
year 1913, and they show that a pneumatic tool for stonework was
introduced several years before this in Germany and its use had in­
creased so much that factory inspectors were instructed to gather
information as to its effect on the health of stone workers. No de­
scription o f the tool used is given, but it is clear that it is a drill
for use in quarries, probably a drill for blasting charges and for
breaking stone. The machines are worked by steam, compressed air,
or electricity.
The inspectors who report on them are concerned with the great
increase in stone dust occasioned by their introduction and with the
possibility o f using water to keep this dust down. Only four times
in more than 20 reports is there any mention of the vibration o f the
18476°—18— Bull. 23fi------ K




66

REPORTS OF PH YSICIAN S REPRESENTING THE BUREAU.

drill. In some places the men are said to use it only a few hours in
the day or to alternate with other work. This last precaution is
insisted on by the inspector for Wiesbaden in his district. It is very
evident that the tool in use is not an air hammer for working up
stone. In the report from one district only, Bremen, there is a pass­
ing mention o f the occasional use o f a pneumatie machine in a marble
shop.
SUMMARY.

Among men who use the air hammer for cutting stone there ap­
pears very commonly a disturbance in the circulation o f the hands
which consists in spasmodic contraction of the blood vessels of cer­
tain fingers, making them blanched, shrunken, and numb.
These attacks come on under the influence of cold, and are most
marked, not while the man is at work with the hammer, but usually
early in the morning or after work. The fingers affected are in
right-handed men the little, ring, middle, and more rarely the index
o f the left hand, and the tips of the fingers of the right hand with
sometimes the whole of the index finger and sometimes the thumb.
In left-handed men this condition in the two hands is reversed.
The fingers affected are numb and clumsy while the vascular spasm
persists. A s it passes over there may be decided discomfort and
even pain, but the hands soon become normal in appearance and as
a usual thing the men do not complain o f discomfort between the
attacks. There seems to be no serious secondary effects following
these attacks.
The condition is undoubtedly caused by the use o f the air hammer;
it is most marked in those branches o f stonework where the air
hammer is most continuously used and it is absent only where the
air hammer is used little or not at all. Stonecutters who do not use
the air hammer do not have this condition o f the fingers.
Apparently once the spastic anemia has been set tip it is very slow
in disappearing. Men who have given up the use of the air hammer
for many years still may have their fingers turn white and numb
in cold w
reather.
According to the opinion of the majority o f stonecutters the con­
dition does not impair the skill in the fingers for ordinary interior
stone cutting and carving, but may make it impossible for a man to
do outside cutting in cold weather or to take up a skilled trade which
exposes the hands to cold.
The trouble seems to be caused by three factors—long-continued
muscular contraction o f the fingers in holding the tool, the vibrations
o f the tool, and cold. It is increased by too continuous use o f the
air hammer, by grasping the tool too tightly, by using a worn, loose
air hammer, and by cold in the working place. I f these features
can be eliminated the trouble can probably be decidedly lessened*




REPORT OF THE PHYSICAL FINDINGS IN EIGHT STONECUTTERS
FROM THE LIMESTONE REGION OF IND IANA .1
B Y THOR ROTHSTEIN, M . D., PKOFESSOH OF STEEVOUS A N D M E N T A L DISEASES,
liU S H MEDICAL COLLEGE, CHICAGO.

GENERAL 'REMARKS.

A ll o f the men examined presented symptoms of (1) marked vaso­
motor disturbances mainly in their hands, and (2) decrease o f sensa­
tion.
1.
The symptoms o f vasomotor disturbance were mainly vasomotor
constriction (whiteness), with some stasis (blood stoppage) when
hands were cold, and vasodilatation (redness) when hands were
warm. These disturbances were brought about by different causes:
(a) Temperature.—A lowering of the temperature causes a vaso­
constriction o f the blood vessels o f the hand to an abnormal degree.
The vasoconstriction was most marked when the hands were exposed
to the out-of-door temperature (February) or put into cold water.
A ll o f the men after such an exposure had at least some fingers which
seemed to be bloodless. An extreme degree o f vasomotor constriction
must therefore have been present. But even slight changes in the
temperature were sufficient to bring about a more or less pronounced
vasomotor constriction. F or instance, if the hands were kept under
the bedcovers until they were warm, and then were put on top of the
bedcovers, thus exposing them to the room temperature, they would
soon become cold and even assume a more or less marked whiteness.
I also observed several times that in the morning before the men had
left their beds their hands were cold, bluish red, and the fingers more
or less whitish.
(&) Mechanical stimuli.— Mechanical stimuli also caused an ab­
normal vasomotor constriction. I f the blunt end of a pencil was
dragged, with some pressure, over the skin o f the hand a white streak
(vasoconstriction) appeared. This white streak did not, as in a nor­
mal person, if* a few seconds change into a red streak, but remained
for many minutes and even spread. Even the stimuli nsed fo r testing
the sensation, especially pin pricks, after a while produced a marked
vasomotor constriction. Under normal conditions pin pricks cause a
vasodilatation.
1 Eight men were examined in Bedford, Ind., during January, 1918, and about a month
later they were brought to the Presbyterian Hospital of Chicago for a more detailed
examination.
67




68

REPORTS OF PH YSICIAN S REPRESENTING THE BUREAU.

( c) Galvanic current.— The galvanic current, instead of bringing
on a vasodilatation, caused in the men a more or less marked and last­
ing vasoconstriction.
2.
Symptoms o f decrease in sensation.— Decrease of the sensation
of touch, pain, and temperature was found. In none of the men was
this decrease o f severe degree. The areas o f skin on which the de­
crease of sensation was found far exceeded those areas which could
actually be in contact with the tools used.
As the decrease in sensation was most marked in the areas which
presented the most marked vasomotor disturbances, it is logical to
assume that the decrease in sensation was a consequence of the vaso­
motor disturbances. One would therefore expect the disturbances in
sensation to vary in some degree with the vasomotor disturbances, for
instance to be of different intensity in the summer and winter.
I had opportunity to examine some of the men twice within two to
four weeks’ intervals in January and February and found the de­
crease in sensation to be practically the same as to extent and degree
at both examinations.
Localization o f symptoms.— The abnormal condition o f the vaso­
motor nerves and o f sensation was found mainly in the hands, but
in some o f the men decrease o f sensation was found in the forearms.
Certain facts point to the possibility of a more general disturbance
o f the sympathetic nervous system being present. In most o f the
men the vasomotor reflexes of the skin were found to be livelier than
normal in parts o f the body other than the hands and arms, and all
o f the men gave me the impression that they were in general un­
usually sensitive to the temperature of the air. They would easily
shiver, even when in the hospital, and when in bed they would cover
themselves up very carefully. It is possible that the functions o f the
vasomotor system of the whole body were altered to a slight degree.
The men complained about a swelling o f the hands. In my notes
on the physical examinations I have not mentioned any swelling.
There existed undeniably a certain degree o f swelling o f the hands
in all the men examined, but it hardly exceeded what would be ex­
pected in men who were doing manual labor in a low temperature.
In one case (No. 7) the little finger of the left hand presented a dis­
tinctly pathological swelling o f the soft parts, the whole finger being
of larger circumference than the right little finger.
*
Several of the men (Nos. 1, 2, 5, 6) had on the dorsum (back) o f
their hands very few hairs. Some areas of the skin of the dorsal
surface of the hands were without a hair. It is possible and even
likely that there had been a falling out of the hairs due to the existing
vasomotor disturbances, but the number of observations is too small
to allow any conclusions to be drawn. The falling out of hairs is,
however, met with in disturbances of vasomotor function.




REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS.

69

One case (No. 8) showed, at least at times, a marked increase in
the perspiration on the palms o f the hands. The increased perspira­
tion had, o f course, some relation to the vasomotor disturbance, but
its significance can not very well be decided upon from so few ob­
servations.
In none o f the men could any degeneration or real weakness of the
muscles be demonstrated, and the electrical reactions of the muscles
were normal. I f any of the men suffered any decrease in their mus­
cular strength I was not able to detect it. In most o f the men the
left arm was smaller in circumference than the right arm, but data
are too few and differences too small#to form an opinion about the
relation between the work and the smaller circumference o f the left
arm.
Urine and blood were examined in all 8 men and in all cases found
to be normal.
CONCLUSIONS.

It can be stated that these examinations have demonstrated the
presence o f marked vasomotor changes and decrease of sensation in
the stonecutters examined. The vasomotor nerves o f the hands were
abnormally sensitive and reacted in a manner never seen in normal
conditions. As the sensitiveness of the vasomotor nerves to mechani­
cal stimuli was most marked in the parts of the body which were in
closest contact with the vibrating pneumatic tool, it is evident that
the vibrations o f the tool must be considered as the cause of the vasor
motor disturbances found in the men.
No symptoms o f a dangerous character were found and the condi­
tion can not be said to be of serious consequence to the general health
o f the men. It is, however, impossible to state that it would not
finally have an unfavorable and even serious influence upon the
health o f the men (or some men). It can not be denied that the con­
dition of the hands of the men I had opportunity to observe is a
handicap, preventing them from choosing certain occupations and
thereby limiting their freedom.
The figures accompanying the following case histories are exact
representations o f the changes of sensation in each man. The sen­
sory disturbances varied in intensity from day to day and it would
be impossible to give more than an approximate description o f the
degree o f change. The character of the disturbances, however, and
their localization are depicted with a very fair degree o f accuracy.
The tests were made while the hands were warm and therefore
show the condition at those times when the hands are as nearly
normal as they ever are. During the anemic spasm the loss o f sensa­
tion is much greater. The hands were then plunged into cold water
and the resulting anemia noted.




70

REPORTS OF PH YSIC IA N S REPRESENTING THE BUREAU*
CASE HISTORIES.
CASE NO. 1, AGE 40 YEARS.

(Exam ined Jan. 18, 1918.)
H ISTO R Y.

Present complaint.—Dead feeling in fingers. Tingling in the
fingers.
Onset and course.— Ever since the patient was 15 years old he has
been in the stonecutting trade. Previous to the last 7 years he al­
ways used the old-fashioned method o f stonecutting, but during the
last 7 years he has used a pneumatic stonecutter. He holds the
tool with the left hand, and holds the hammer between the thumb
and the forefinger o f the right hand. The complaints mentioned
above are never noticed in the summer unless the weather is cold,
but in the winter time the condition is very marked. Even in the
morning when the patient gets out of bed to shake the stoves in
cold weather his fingers on both left and right hands get white,
numb and cold. As long as he is out in the cold his hands are
in this condition, but if he keeps them warm they feel comfortable.
He generally warms his hands verj carefully before he leaves home
in the morning and puts on thiek gloves to keep them warm. But
when he uses the tool at work it seems that the vibration o f the
machine “ drives out all the blood from the fingers ” and causes them
to become white and cold. When he drops the tool and goes to
warm his hands the fingers become red and tingle. I f he gets out in
the cold air or puts his hands in the snow they become white and
44dead.” The colder it is the more “ dea d ” they become. I f he
strokes the fingers from above, below or vice versa the skin gets white
instead of red. This condition (the whiteness) lasts for a consid­
erable while.
Present condition.—When the numbness in the fingers first started
only the very tips o f the fingers were involved, but as the condition
gradually became more pronounced it involved all the fingers of the
hands with the exception o f the right little finger. He thinks the
condition is gradually spreading. Anything he grips for some
length o f time causes the fingers to become white and a dead.” When
the fingers are white and cold he can not at times distinguish the
coins in his pocket. H is hands always look bluish red.
Past history.— Measles, when young. No typhoid, scarlet fever,
or other diseases o f contagion. No frequent sore throats or colds.
Has varicocele (enlargement o f scrotal and spermatic veins). No
operations. No accidents, jars, or injuries.
Family history.— Father dead, 74 years of age, cause unknown.
Mother dead, 71 years of age, asthma. No brothers. One sister, liv-




REPORT OF PH YSICAL FINDINGS IN EIGHT STONECUTTERS.




71

72

REPORTS OF PH YSICIANS REPRESENTING THE BUREAU.

ing and well. W ife’s father died of consumption. No cancer, no
insanity, no strokes.
Marital history.— Married 20 years; six children living, two dead
(one at 1 month, another at 17 months), two miscarriages brought on
by work. W ife subject to stomach trouble. No stillbirths.
Venereal history.— Denied.
Habits.— Tobacco— Chews all day; smokes six to twelve pipefuls
a day, and cigars occasionally. Alcohol—Moderately only at times;
no whisky. Coffee— Scarcely any. Appetite good.
GENERAL FEATURES.

Head.— No disturbances. No aches. No eyestrain or tiredness.
No visual disturbances. Teeth very bad; all ulcerated and only
roots remain o f the most o f them. No sore throats.
Chest.— Lungs and heart— No disturbance.
Gastrointestinal.— No indigestion. Appetite excellent. No nausea
or vomiting. Tendency to constipation.
Genito-uriomry.— Bowels move every other day. No frequency,
pain, or burning on urination. Does not get up at night. No dis­
turbance in flow.
E X A M IN A T IO N .

Pupils unequal—Right, 4 millimeters in diameter; left, 3 milli­
meters. Both pupils react to light and accommodation.
Pinching of skin in neck gives some, but not very great, dilata­
tion o f the pupils.
Patellar reflexes (knee jerk) present. Oppenheim’s reflex present
on right side. Babinski1 negative on both sides. Abdominal reflex
present both sides. Cremasteric2 present both sides. The vasomotor
reflexes of the skin ver ymarked. Idiomuscular reaction 3 marked.
Hands.—When hands were kept under the bedcover they were
w
rarm and red, but after hands had been on top of bedcover for half
an hour they began to become cold and later became bluish and of a
dusky red color. The skin of the hands was cold up to the wrist.
The hands were made warm by covering them and then the sensation
tested.
Sense o f touch.—Left hand: Sense of touch is decreased over the
whole dorsum of hand and fingers. The decrease is, however, less
marked on basal phalanx o f little finger and the ulnar4 part o f
dorsum of hand. On the volar (palmar) side the decrease in sen­
1 Dorsal extension of great toe on tickling of sole of foot.
2 R etraction o f testicle on sam e side upon s tim u la tio n o f skin on fr o n t and inner asp ect
o f thigh.
3 C o n tra ctio n o f tired m uscle under certain con ditions o f extran eou s stim u lu s.

4 Toward ulna or large bone on inside of forearm.




REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS.

73

sation is indistinct. Sense of touch is also decreased on ulnar half
o f the left forearm. Eight hand: Sense of touch is slightly de­
creased on radial1 part of dorsum of hand and on dorsum o f the
fingers. Decrease in sense of touch is slight and less than on left
hand.
Sense o f pain.— Sense of pain is decreased on dorsal surface o f left
hand and fingers. On the right hand sense o f pain is decreased on
dorsum o f hand and fingers, but not as much as on corresponding
points on left hand. On the dorsal surface of forearms, especially
left forearm, pain sensation is not as easily elicited as in a normal
man.
Sense of temperature.—Temperature sensation is decreased on
hands both dorsal and volar surface, and on all the fingers. The de­
crease is very slight on right hand, but more marked on left.
A fter the hands had been put into cold water for four minutes all
the fingers on left hand became white up to the middle o f basal
phalanx, and all fingers on right hand excepting the little finger
also became white, but not as white as fingers on left hand. The
palm and dorsum of hand is pale but bluish on left hand, while the
corresponding parts on right hand are more of a bluish red.
In pointing tests the right hand is accurate but left hand is not
quite accurate, a slight decrease o f sensation o f position existing in
left arm.
Left arm— circumference, 26.5 centimeters.
Right arm— circumference, 27 centimeters.
No marked perspiration on palms of hands. Skin is soft and thin
on dorsal surface of fingers and hands.
CASE NO. 2, AGE 26 YEARS.

(Exam ined January 18, 1918.)
H ISTO EY.

In January, 1918, he had worked asf a stonecutter for 14 years,
working with the air hammer 3| years. Fingers on left hand become
white and numb when weather is cold. Index, middle, ring, and
little fingers show this condition. During work his fingers at times
become numb and white, but not always. Fingers on right hand do
not become white.
E X A M IN A T IO N .

Pupils equally react to light and accommodation and pain.
All reflexes are present and normal.




1 Toward thumb side of forearm.

KEY

REPORTS
O
F

Horizontal limes * decrease in
sense o f touch
D iagonal lines = d ecrease in
sense o f pain

A=marflin of anfcmic area after
imfneVAi'on in cold water
Bamangin of whitiflh-blue area
The closer the lines the more pro­
nounced the decrease in sensation

REPRESENT!NO

V-shaped marks = decrease in
sense of heat and cold

PHYSICIANS
THE

Fig. Z -H a n d s of Cask No. Z

BUREAU,




•<T

REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS.

7-5

Tremor in both hands and in tongue.
Vasomotor reflexes o f skin somewhat increased.
Teeth in good condition.
Eight forearm 27.5 centimeters in circumference; left 26.5 centi­
meters.
Hands.—On the day o f the .first examination, although case No.
2 had been in bed for several hours, his hands were cold. The
fingers of left hand, except thumbs were distinctly pale and some­
what bluish, and skin over the metacarpophalangeal joints (toward
palm) was whitish. Hands as a whole were bluish red.
The second examination on the following day was also given with
Case No. 2 in bed. His fingers and palms o f hands were cold but
skin on dorsal surface of hands was warm. After his hands had
been warmed there was a marked moisture on palms of hands.
Sense of touch is decreased on fingers and dorsal surface of left
hand.
Sense of pain is also decreased on fingers, dorsum and palm o f
left hand.
Sense o f temperature is distinctly decreased on fingers o f left
hand; 18° C. and 37° C. are not distinguished with certainty. Sen­
sation on right hand does not present any marked decrease.
A fter hands had been put into cold water for one minute they were
dried. The fingers on left hand are distinctly pale (see fig. 2) and
remain so, while the rest of the left hand and- whole right hand are
purple in color. The whiteness o f the fingers is not so marked in
this man as in the other cases.
CASE NO. 3, AGE 45 YEABS.

{E xam ined Feb. 1, 1918.)
H ISTO R Y.

Present complaint.—Turning white ^of the hands when cold.
Numbness o f the fingers when cold.
Onset and course.— Has been a stonecutter for nearly 26 years.
Twelve years ago he started to use a pneumatic stonecutter and
has worked with it on an average o f seven hours a day. He holds
the hammer in the right hand and the tool in the left, and there is
a constant vibration of the iool and the hammer. This affects the
left hand most. About 75 to 80 pounds of compressed air are behind
this hammer. The first three years he used it for only about half
o f the sh ift; the next four years he did not use it at a ll; but for the
last four years he has used it all the time. During the four-yea
interval his hands appeared to be normal. They did not get cold o
numb.




76

REPORTS OF PH YSICIAN S REPRESENTING THE BUREAU.

When he first started to use the hammer his hands would swell
but did not get white or numb, but when he had used the hammer
for a year or a year and a half they began to get white and numb.
The whiteness and numbness come on only in cold weather. The
little and ring fingers of the left hand were the first parts to show
the symptoms mentioned. At first only the distal1 portion o f the
fingers were affected by the whiteness and numbness. Then these
symptoms gradually extended upward and also involved the middle
and index fingers, till now the four fingers are affected up to just
above-the second joint. The thumb is not affected as much as the
other fingers. The right hand is less involved than the left and
does not get white, but cold and numb. The left hand began to get
cold and white and numb earlier than the right. He does not notice
any disturbance in warm w^eather, but as soon as the cold of the
winter sets in the symptoms come on. The hands do not get white
T
and numb in the house, but when he steps outdoors in the cold the
hands get as mentioned. He has to thaw them out before going to
work with the tool.
Present condition.— Now the condition is more marked in fingers
of left hand up to past the second joint. The left hand is always
cold and becomes whitish and numb in cold weather. The right
hand becomes only cold and numb.
Past history.— Measles, chicken pox, and mumps when a child.
Bronchitis at about 39 years of age. No operations; no injuries; no
convulsions; and no other nervous disturbance.
Family history.— Father dead, 69 years, quick consumption.
Mother dead, 75 years, heart trouble. Brothers, three living, well
and strong, and one dead, fractured skull. Sisters, four, all living
and well. No tuberculosis or cancer, insanity or nervous dis­
turbances.
Marital history.—Married 15 years; wife well; three children, all
well. None dead, no stillbirths. One miscarriage at three months
brought on by overwork.
Venereal history.— No gonorrhea or luetic infection.
Habits.— Tobacco— Smokes five to six cigars a week, no pipe or
cigarettes; chewT 5 cents’ worth a day. Alcohol—None. Coffee—
s
Hardly two cups a day. Tea— Occasionally. Appetite excellent.
GENERAL FEATURES.

Head (physical examination Feb. 3, 1918).—Wears glasses all the
time. Vision normal. Pupils normal, react normally. Hearing is
very good. No tinnitus (ringing) or noises. No frequent sore
throats or colds. Teeth in good condition.




1 At greatest distance from body.

KEPOET

A = margin of anemic -area after
immersion in cold wa+er

nounced the decrease in sensation

F IN D IN G S

The closer the lines the more pro­

P H Y S IC A L

V-shaped marks = decrease in
sense, o f heat and cold

O
F
IN

F ig . 3 - H a n d s of C a s e N o . 3

EIG H T
STON ECU TTEES.

77




Key

78

REPORTS OF PH YSICIAN S REPRESENTING TH E BUREAU .

Thorax.— No symptoms referable to heart or lung disturbances.
Gastrointestinal.— No indigestion, vomiting, nausea, or headaches.
Bowels move normally every day.
TJrinary.— No frequency at night; no burning or pain on uri­
nation.
E X A M IN A T IO N .

Reflexes,—A ll tendon reflexes and skin reflexes present and
normal.
Rands.— The idiomuseular reaction very marked. Palms moist.
The little fingers become the whitest.
The skin on all the fingers and volar and dorsal surface of both hands
is cold. When he stretches out the fingers the skin becomes whitish
on the dorsal surface around the joints of the basal and middle
phalanx, while the skin on the middle portion o f the phalanges and
the dorsum of the hand is bluish. The little fingers show the most
marked whiteness. On the volar surface of the fingers and in palms
the skin is bluish red. When he relaxes the fingers this whiteness dis­
appears. Massaging o f the hands produces slight whitening, which
disappears only slowly. Skin temperature on both hands 22° C.
Sense o f touch.— Normal.
Sense o f pain.— No marked disturbance.
Sem e o f temperature.— Temperature of 39° C, and 30° C. he can
not distinguish with either hand with certainty even when grasping
the tube tightly. Neither can he distinguish between 35° C. and 24°
C. Once in a while after long exposure he will say 35 is the warmest,
but just as frequently he will say 24-is just as warm. 18° C. gives
him the sensation of coldness, but no temperature above this degree
is felt as cold on the hands. The right hand will feel the cold sensa­
tion more quickly than the left. Temperature o f 34° C. and above
will seem a little warmer on the right hand than on the left. Above
the wrist, sensation to temperature is normal.
After he has had his hands in snow a little while the fingers of
left hand get perfectly white in the two extreme phalanges, but
the thumb only on the end phalanx. The skin on the basal phalanges
is white on its distal portion but becomes o f a more reddish tint
toward the phalangometacarpal joints. The skin over the meta­
carpus is bright red.
On the right hand the skin becomes red over the distal two
phalanges; same red tint as on the left side. This bright red color
gradually disappears on the left hand in the course of two minutes
and the skin takes on the same shade as the dorsum of the hand.
After five minutes the skin over the two extreme phalanges of left
index finger becomes dark blue on the dorsal aspect but remains




REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS.

79

pale at the same time, i. e., the skin seems partly pale and partly
pale bluish color.
Left forearm, 26.5 centimeters in circumference; right, 27 centi­
meters in circumference.
When visited in the hospital where Case No. 3 spent all o f one day
and part o f the next, his fingers on both hands were cold and the
fingers o f both hands were pale and partly bluish. Upon putting
the middle finger o f the left hand into cold water for two minutes,
all of the fingers on left hand became whitish and cold, the middle
finger the coldest. After eight minutes all fingers on left hand were
redder than the fingers on the right hand, and were cold.
When in bed and keeping his hands under the bedcover his hands
would be warm and moist, but after they had been placed on top of
the cover for a short while their temperature would become lowered
and fingers become pale. Any testing o f the pain sensation would
increase the paleness.
CASE NO. 4, AGE 28 TEARS.

(Exam ined Feb. 11, 1918.)
H ISTO R Y.

Present complaint,— Numbness, coldness, whiteness, pamfulness,
and tingling in the hands and fingers when the weather is cold.
Swelling o f the left hand and fingers all the year round. Weakness
o f fingers and hands when numb.
Onset and course.— The patient has been in the trade since 1909.
He worked for two years with the air hammer, after which he used
the mallet for two years. Then he went back to the air hammer and
has used the hammer ever since. After about two and one-half
years, patient noticed a whiteness, numbness, and coldness in the
left ring finger coming on during work, especially on cold days.
The ring finger he uses to support the tool with. The whiteness in
this finger was always more extensive than in the other fingers.
Then the condition progressed slowly and soon all the terminal
phalanges o f the left hand with which he used the tool were involved.
During the following winter the numbness began to affect also the
middle phalanges of the fingers. About 1915 he noticed a numbness
in his right index finger and it was only about last June that he
noticed on a cold day a distinct whiteness o f the other fingers of this
hand. The index finger is the most affected on the right hand while
the little and ring fingers are practically free from numbness. The
hammer is held between the index and middle fingers. The fingers
become white up to the metacarpophalangeal joints.




80

REPORTS OF PH YSICIAN S REPRESENTING THE BUREAU.

This left arms gets sleepy very readily and feels numb when he lies
down in bed.
A t times when the hands are recovering from coldness and numbness they become so painful he can “ hardly stand it.” The numb­
ness and whiteness of fingers come on in same way and seem to be
influenced by the same conditions as in the other men.
Past history.—Measles, when a child. Always strong and healthy.
No operations. No injuries.
Family history.—Father dead, 40 years o f age, broken nos.
Mother dead, 49 years o f age, cancer o f stomach. Brothers, two
dead, one living and well. Oldest died o f tuberculosis. Sisters, one
living, one dead. Pneumonia caused death. No tuberculosis, cancery
insanity, or nervous disturbance.
Marital history.—Married five years; two children, one dead, mis­
carriage at seven months. No stillbirths. W ife well. Children
strong. Divorced and remarried.
Venereal history.— Gonorrhea, twice; mild attacks. Chancre, two
years ago. Treated with 606 twT
ice, two years of mercury treatment.
Habits.— Alcohol— never to excess. Tobacco— One package o f
cigarettes a day. Chews moderately; 10-cent plug a week. Coffee—
one cup a day. Tea—one cup a day. Appetite excellent.
GENERAL FEATURES.

Head.— Was once hit in left eye with a piece o f stone. Left eye
weak. Vision poorer in left eye than in right. No headaches.
Slight dizziness. Toothaches. No sore throats now but had some
during syphilis. No loss of hair.
Lungs.— No symptoms.
Heart.— N ormal.
Gastrointestinal.— Slight constipation.
No indigestion.
Heart­
burn after dinner. No vomiting.
Genito-urinar'y.— Nothing abnormal.
E X A M IN A T IO N .

Pupils equal, react to light and accommodation, but left pupil
reacts sluggishly. Hearing is decreased in right ear. Hears watch
10 centimeters away from ear. No paralysis in any part of the body.
Abdominal reflexes lively. Cremasteric reflexes lively. Patellar
reflex present but rather hard to get. Achilles tendon reflex1 pres­
ent. No Babinski reflex. Plantar reflex2 lively. Vascular reflexes
lively and long lasting. Idiomuscular reaction present.
1 C on traction o f m uscle o f c a lf o f leg on ta p p in g o f the cord a t back o f heel.
2 C on traction o f toes on irrita tio n o f sole o f foot.




REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS.

18476°— Bull. 236—-18------ 6




82

REPORTS OF PH YSICIAN S REPRESENTING THE BUREAU.

Sem e of touch.—Hands were made warm before sensation was
tested. Skin not thickened on dorsal surface, excepting on right
middle finger (see fig. 4). The sensation to touch is decreased on
both hands, and does not seem quite normal on the forearms. On
the forearms a heavier stroke by cotton has to be used than in a
normal man to give sensation. Above elbows on both sides sensa­
tion to touch is normal. Sensation to touch is not equally decreased
on all parts of hand but is decreased on both dorsal and palmar sur­
faces. The decrease is more marked on index fingers of hands and
least marked on the little fingers and thumb. On the right hand
sensation is markedly decreased on index finger, radial half o f mid­
dle finger, and radial part o f hand (see fig. 4).
Seme o f pain.—He is very uncertain in distinguishing between
sharp and dull on fingers and dorsal surface o f left hand and pin
pricks on penetrating the skin are not felt as pain and only occa­
sionally as sharp.
On little finger, sensation to pain is less decreased than on other
parts o f hands. On palm of hand sensation to pain is less decreased.
On the right hand sensation to pain is also decreased on all fingers
and dorsum of hand. He is unable to distinguish between dull and
sharp on index finger, radial half o f middle finger and radial part
o f hand (see fig. 4). On the other fingers and on ulnar part o f
hand sensation to pain is much less decreased. On, dorsal surface o f
forearms sensation to pain is also somewhat decreased.
Seme o f temperature is decreased on both hands. He can dis­
tinguish on all parts o f hands between temperature of 43° C. and
20° C., but stimulus has to remain longer on skin than normally in
order to be recognized. He is, however, unable to distinguish with
any certainty between temperatures of 29° C. and 34° C. on either
hand, no matter how long stimulus remains in contact with skin.
During the testing of the sensation his hands became cold and had
to be warmed again by patient putting them under the bedcover.
After hands had been placed in cold water, the fingers became whit­
ish (see fig. 4) and rest of hands reddish blue. When hands had
become warm again there was a marked perspiration in palms o f
hands.
CASE NO. 5, AGE 24 YEARS.

(Exam ined Feb. 13. 1918.)
H ISTO R Y.

Present complaint.—Whiteness, numbness, coldness of hands and fin­
gers in cold, damp, or chilly weather. Pain in fingers when blood
comes back. Tingling o f fingers when cold. Swelling of fingers!




REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS.




83

84

REPORTS OF PH YSICIAN S REPRESENTING THE BUREAU.

when cold. Awkwardness, clumsiness, and inability to feel, or to per­
form precise movements when hands are cold. Pain in the left
shoulder lately.
Onset and course.— Has been in trade approximately eight years
and has always used the pneumatic tube an average o f six hours a
day. Trouble first began in the right hand about twT years after he
o
started to use hammer. It first started by terminal phalanges be­
coming white in chilly or cold weather and then progressed until
now the symptoms which he complains of affect four fingers past
the second finger joints. The thumb is only affected in a small re­
gion on the tip, where there is the same trouble. He soon afterwards
noticed the condition in the ]eft hand, beginning in the little and
ring fingers and gradually involving these fingers up to. the metacar­
pal joints. The middle and index fingers are now also involved up
to above the second phalanx. The thumb is involved only a little,
just enough to say it is beginning. The little, ring, and index fingers
of left hand are affected more than the other fingers. He notices
numbness and a dead feeling and is unable to feel things and to do
precise movements when fingers are white. His fingers swell and
throb when the blood comes back to the fingers. There is throbbing
of pulse with pain and tingling and it feels as if the ends o f the
fingers would burst open. Hq notices after hands have “ been dead
and are beginning to come back ” a white and red mottling o f skin,
T
especially on his palm. His hands get numb in the morning and
then again at noon, and about 3 or 4 in afternoon. It seems that his
hands get numb and cold more easily in the afternoon than in the
forenoon and sometimes they stay dead three or four hours at a time.
His fingers swell. The condition came on slowly and is progressing
gradually.
Past history.—Always well as child and young adult. Measles
about two years ago. No operations. No sickness other than above
complaints.
Family history.— Father living and well, 59 years o f age. Mother
living and well, 54 years of age. Brothers, three living, none dead.
No sisters. No insanity, tuberculosis, cancer, strokes, or nervous
disturbances.
Marital history.—Married four years, no children living. Two
born dead, full term. One breech presentation; other cord around
neck. No miscarriages. W ife well.
Venereal history.— Gonorrhea and syphilis— Denied.
Habits.— Tobacco— Two cans a week. Alcohol— Seldom. Coffee—
Two cups a day. Appetite good.
GENERAL FEATURES.

Negative.




REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS.

85

E X A M IN A T IO N .

Head.— Scalp, negative* Eyes react, to light and accommodations,
No hemianopsia,1 strabismus,2 nystagmus.3 Pupils round and regu­
lar. Mouth— No large tonsils; teeth fair; tongue protrudes straight.
No cranial nerve palsies.
Neck.— Negative. No adenopathy4 anywhere.
Chest.— Negative.
Abdomen.— Negative.
Reflexes.—Wrist, elbow, knee, ankle, plantar, abdominal, and crem­
asteric reflexes present. Right and left equal. Babinski negative.
Coordination.— No gross disturbances.
Sensation.— Lower extremities and trunk negative. (See state­
ment as to hands, below.) Feet moist and clammy.
He presents markedly the symptoms o f dermographia5 with for­
mation of urticaria factitia6 on the skin.
Idiomuscular reaction is very marked in all muscles.
Hairs are very few on dorsum of hands.
Sense of touch.— When hands are warm there is only a very
slight decrease of sensation to touch on dorsum of the fingers of
both hands. When hands are cold the sensation is much decreased,
but not equally so on all parts. The decrease is most marked on little
and ring fingers of left hand and index, thumb, and long finger o f
right hand.
Sense o f pain.— Pain sense is decreased on dorsal surface o f
fingers and dorsum of hand, both on left and right hand. It is also
decreased on dorsal surface o f right forearm.
Sense o f temperature.—Temperature sense decreased on hands and
fingers.
Hands were kept warm during examination.
When hands were put in cold water, and then dried, fingers
showed whiteness. (See fig. 5.)
CASE NO. 6, AGE 38 YEARS.

(Exam ined Feb. 6,. 1918.)
HISTO R Y.

Present complaint.—Weakness in the fingers. Coldness in the,
hands. Whiteness of the fingers when cold; otherwise whitish
1 B lin d n ess in h a lf th e visu a l field.
2 A b n o rm a lity o f eyes in w hich v isu al axes do n o t m eet a t desired objective point.
3 O scilla to ry m ovem ent o f eyeballs.
4 A n y disease o f g lan d or gland s.
5 C ondition o f skin in w hich w ords or m ark s m ade on skin leave m ore or less p e rsisten t
traces.
6 W h ite or pinkish ridges.




86

REPORTS OF PH YSICIAN S REPRESENTING THE BUREAU*

patches over the fingers. Numbness and dead feeling in the hands
and fingers when cold. Sleepy feeling in the arms in the early
morning. Rheumatoid pains in hands and muscles of arms.
Onset and course.— The patient has been in the stonecutting trade
for 20 years, and has used an air hammer for 13 years, with the
exception o f 1| years when he worked as a barber. He has used the
pneumatic stonecutter on an average of 6 to 7 hours a day. About
1J years after he started to use the air tube, which has about 70 to 75
pounds o f compressed air back of it, he noticed the tip o f his right
index finger getting white, especially in weather which was damp
and cold, and even on cooler days during the summer.
Gradually the whiteness involved more and more of the index
when he worked .under the named conditions and even the other
fingers became involved until the whiteness when present would take
in all the fingers of right hand. Later the whiteness involved left
hand, beginning in the same manner and involving the same parts
as on the right hand. This whiteness and coldness has been accom­
T
panied by numbness and a dead feeling and on occasions his hands
tingled and pricked so that it almost made him cry. This occurred
as it seemed when blood would rush back to the fingers, after ex­
posure to cold weather.
Cold water caused the whiteness to appear. In the summer he
has noticed a swelling of the fingers. This swelling comes on mostly
in the morning, after washing, and makes it difficult for the patient
to shut his hands.
Just lately he has noticed that his fingers are not as strong as they
formerly were and when he tries to grasp things his fingers give way.
In the morning before getting up, his arms feel dead and weak.
However, he rubs them and finally they feel better. He notices the
same thing in the night after returning from work. His arms ap­
pear to go to sleep and he feels a creeping movement in the ends o f
the fingers. They seem to “ wake up.”
During work he has to shake his hands to get the blood down. I f
he washes his hands in cold water they get white. When he is in the
house by the fire he does not notice the whiteness or numbness, but
the hands feel weak.
When he leaves his home in the morning the minute the cold air
strikes him his fingers get white, cold, and numb. When he throws
his hands down violently the rush of the blood to the end of the
fingers produces a tingling, creeping feeling.
Present condition.—The condition has been getting worse and now
he notices also the weakness mentioned above.
Past history.— No childhood diseases. Frequent colds. Occasional
tonsilitis. No operations. No severe injuries.




REPORT OP PHYSICAL FINDINGS IN EIGHT STONECUTTERS.




87

88

REPORTS OF PH YSICIAN S REPRESENTING THE BUREAU.

Family history.— Father living and well, 65 years. Mother living
and well, 63 years. Brothers, two living and well, one died at one
year of age. Family always healthy and live to old age. No tubercu­
losis, cancer, insanity or nervous disturbances in family.
Marital history.—Married 12 years. Five children living, five chil­
dren dead: One at 11 months, of pneumonia; one at 43 days; twins
at 7 months, of indigestion; another at 1 month, cause unknown.
One miscarriage at two to three months. No stillbirths. W ife quite
healthy.
Venereal history.— Denied.
Habits.— Tobacco— Chews occasionally, smokes four to five ciga­
rettes a day, no pipe or cigars. Coffee— One cup a day. Tea— Occa­
sionally. Appetite— Excellent. Bowels— Fairly regular.
GENERAL FEATURES.

No symptoms referable to disturbances in other organs.
E X A M IN A T IO N .

The examination was made in room temperature. Hands and fin­
gers warm, with exception o f fingers on left hand. Palms not moist.
Color of skin dusky red and bluish up to wrists, beyond which it is
of practically normal color. The left hand differs from the right,
the fingers Being pale and cold up to above the second phalanx. The
right is more bluish red than left. When he shuts his hands and
squeezes them tightly together for a moment the palms of the hands
and the palmar sides of the fingers remain white and bloodless, blood
not returning to skin as in a normal hand. This condition is more
marked in left than right hand. Stroking the skin on backs of hands
produces a whitish coloration which spreads and remains for a
,
couple of minutes.
Sense o f touch.— There is slight decrease of sensation of touch on
the fingers o f both hands, more marked on the end phalanges.
Sense o f fa in .— Sensation to pain is greatly reduced on both hands*
Hard pressure with a pin point is felt only as a pressure, and only
occasionally as pain on dorsum of hands and fingers, and even pene­
trating pricks are only at times felt as pain. On the palmar surface
of hands and fingers the sensation of pain is also much decreased, but
not so much as on the dorsal side. The decrease in sense o f pain is
most marked on the end phalanges of the fingers and gradually be­
comes less toward the wrist. On the forearm the sensation to pain
is about normal on the volar side, but distinctly decreased on the
dorsal side up to the elbow. The decrease in sensation to pain is,
however, less marked on the dorsum of forearm than it is on thei
dorsum of the hand.




REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS.

891

Sense of temperature.— Sensation to temperature is also decreased
011 both hands. He can distinguish between temperature of 37° C.
and 24° C., but test tubes have to be left much longer in contact with
skin than is necessary in a normal man, and even at temperature of
40° C. he does not feel always as warm if the contact has not been
prolonged for four to five seconds.
During the testing of the pain sensation the fingers on both hands
become pale and cold, the pricks with the pin evidently causing a
marked vasoconstriction, instead of, as normally, a vasodilatation.
The hands were put into cold water for three minutes, and then
dried. The fingers were now white up to a little past the middle of
the basal phalanx. In the region of the phalangometacarpai joints
the skin was o f a bright red color and shaded off from red to bluish
red up to the wrist. The skin on the wrist and above had normal
color. Both hands were practically alike in color, but the changes
were slightly more marked on the left hand. A fter eight minutes
the hands began to change to a more normal color, but even after 15
minutes some whiteness still remained in the fingers.
The hands and fingers were rubbed and after the blood circulation
seemed more normal were left to rest for several hours. After this
period o f rest the muscles o f the hands were tested with the gal­
vanic current. The reactions were normal, but during the applica­
tion o f the galvanic current to the hands, the fingers on both hands
became cold and whitish. A few minutes after the galvanic current
" had been stopped the fingers became warm and red, and also showed
marked perspiration.
Pupils reacted normally, and were of normal size.
Tendon reflexes in arms normal.
Achilles tendon reflexes
normal. Foot sole reflexes, cremasteric reflexes, and abdominal re­
flexes normal. No Romberg symptoms,1 no ataxia, no enlargement
o f lymph glands.
On the dorsum of the hands the hairs are unusually few, but the
hairs are also sparse on his legs.
CASE NO. 7, AGE 24 YEABS.

(Exam ined Feb. 13, 1918.)
H ISTO R Y.

Present complaint.— Coldness of hands and fingers in damp, chilly,
and cold weather. Aching pain in the right shoulder and upper
arm; whiteness of the hands and fingers in cold, chilly, or damp
weather. Numbness and tingling, “ dead feelings,” in fingers. Pain
when blood returns to fingers after whiteness.
1 Increased in coo rd in ation o f m ovem en t,
fe e t in ju x ta p o sitio n and closin g the eyes.




in

lo com otor

ata x ia ,

caused

by p la cin g th e

90

REPORTS OF PH YSICIAN S REPRESENTING THE BUREAU.

Onset and course.— The patient has been a stonecutter for eight
years, and has used the pneumatic cutter on an average o f seven
hours a day for eight years. He holds the hammer in various ways,
but usually with the thumb and first three fingers. Occasionally he
rests the little finger of the right hand on the tool. He grips the
tool with all fingers of the left hand. The thumb o f the left hand
is not used much in holding the tool, but the thumb o f the right
hand is used much.
After he had been working with the pneumatic cutter for two
years he noticed on days when weather was damp and chilly or
cold that during the work he would get a feeling of numbness in the
little finger on the left hand and this finger would become white and
cold. A t first only the terminal phalanx w as affected, but gradually
T
the whiteness and numbness, when present, extended up to the
metacarpophalangeal joint. Later the ring finger and still later the
middle finger became affected in the same way as the little finger, the
symptoms first appearing in the ends o f the fingers and then gradu­
ally spreading upward until nowrthe middle and end phalanges o f
these two fingers are affected. O f the index finger only the extreme
phalanx is affe ted by the whiteness and numbness, while the thumb
is hardly involved at all. Lately the right thumb and forefinger
show some symptoms in the terminal phalanx. They do not actually
become white, but have a “ dead numb ” cold feeling. The middle,
ring, and little fingers on right hand have escaped thus far. The
condition seems to him to be progressing. Sometimes it appears as ~
“ though the fingers become swollen.” Some mornings before the
kitchen fire is made the left hand will get numb, white, cold, and
“ dead.” He swings his arm and throws it forward, repeating this
movement until hand gets warm. He feels the blood “ rush toward
the hands ” when he swings his arm. The pulse starts to throb and
then the hands begin to tingle and ache. I f he tries to warm the
hands before the fire the pain is more severe. The hands feels clumsy
and it is hard to do things when they are cold. It is difficult to feel,
and control is lost when the hands are cold. He has noticed no dis­
tinct weakness. When going to work the fingers get cold and
especially when they grip things, like the lunch basket, etc. He
T
always warms up his hands before starting work. The hands seem
to become white and cold more easily right after dinner. Coming
home from work in the evening his hands are bad. He sometimes
gets a pan o f cold water to keep his hands from warming up too
quickly. Thus he avoids pain. The right arm aches during the
night at times and w^akes him. When he goes away from work for
a time, a month or so, and then comes back, the back of his hand
will ache and feel peculiar from the vibration o f the instrument.




REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS.




91

92

REPORTS OF PH YSICIANS REPRESENTING THE BUREAU.

Past history.— Measles and mumps when a child. Colds in nose,
influenza. No operations; no severe accidents.
Family history.— Father living and well, 56 years. Mother liv­
ing and well, 53 years. Brothers, three living, none dead. Sisters,
two living, none dead. No tuberculosis, cancer, insanity, or other
nervous condition in family.
Marital history.— Nearly three years. No children. W ife well,
not strong. No miscarriages. No pregnancies.
Habits.— Tobacco— Smokes pipe, twT cans of tobacco a week.
o
Does not chew. Alcohol— Occasionally. Coffee— Two cups a day.
Appetite very good.
general

features.

Head.— Eyesight good. No headaches. No disturbance in hearing.
Teeth good. No sore throats.
Chest.— Lungs— Negative as to symptoms.
Gastrointestinal.— No indigestion, nausea, or vomiting. Bowels
regular.
Urinary.— No frequent urination. No burning or pain.
Joints O. K.
E X A M IN A T IO N .

Head.— Scalp— Negative. Eyes—Pupils react to light and accom­
modation. Pupils round, regular but unequal. No nystagmus, stra­
bismus or hemianopsia. Right pupil 5 millimeters; left pupil 4
millimeters. Ears—Hearing a little deficient on right side. Nose—
No discharges. Mouth— Tonsils not enlarged. Teeth good. Tongue
protrudes straight. No cranial nerve palsies.
Neck.— N egative.
Chest.— Lungs and heart negative.
Abdomen.— Negative.
Reflexes.—Wrist, elbow, knee, ankle, abdominal, cremasteric, plan­
tar present. Right and left equal. The vascular reflex in skin comes
slowly. Babinski negative. Indiomuscular reaction very marked in
muscles o f arms and chest but not so marked in leg muscles.
Hands.— Before hands w ere tested they had been kept under the
T
bedcover for some time to keep them warm.
Sense o f touch is slightly decreased on both dorsal and volar
surface o f all fingers of left hand except the thumb. Sense o f touch
on the palm and dorsum of left hand is practically normal. On the
right hand the sense o f touch does not seem to be quite normal on
I the fingers, but the decrease, if any, is so slight that it is insignificant.
[Above the wrist the sense o f touch is normal on both arms.




REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS,

93

Sense o f pain.— Can distinguish between a sharp point and a blunt
point with nearly normal accurateness on fingers and hands on both
sides, but penetrating wounds are only occasionally felt as pain on
dorsum o f hands and fingers of both left and right side. Above the
wrist the pain sensation is about normal.
When the testing of the sensation o f pain and temperature started,
both hands were warm, but after the testing had proceeded some time
the temperature of skin on hands had become distinctly lowered
and his hands had to be put under cover to warm up again. When
finally the tests had been finished, the hands were allowed to remain
on top of cover. The fingers o f left hand became cold and bluish
white (thumb and index less than the other fingers). The whole
palm o f left hand is cold, while the skin on the dorsum is much colder
on the ulnar half than on the radial half. The skin on right hand
also became cold, but did not show as marked change as skin on the
left hand; however, the two extreme phalanges of the fingers became
cold, but not distinctly anemic. The thumb on the right hand did not
become cold during the test.
• Sense o f temperature.—He distinguishes quicker and with more
accuracy between temperature o f 20° C. and 40° C. on the right hand
than on the left. He is able to distinguish between temperature be­
tween 25° C. and 33° C., but the exposure has to be made longer arid
the exposed surface has to be larger than in a normal person. The
palms of hands showed marked perspiration when warm.
CASE NO. 8, AGE 33 YEARS.

(Exam ined Feb. 11, 1918.)
HISTO R Y.

Present complaint.— Hands cold, though only in cold weather.
Numbness of hands and fingers. Tingling of hands and fingers.
Soreness o f elbow after prolonged use of right arm. Weakness and
loss of grip of fingers when hands are cold. Swelling of the fingers.
Whiteness of the fingers when cold.
Onset and course.— The patient has been in the'stonecutting trade
18 years and has been using the air hammer, on an average, 6 hours
a day. This is not done every day because some days the mallet is
used. Though the patient does not remember absolutely, he thinks
his trouble began with whiteness in the fingers of the left hand 10
years ago. It involved the left little finger first. He holds the tool
so that much o f the weight falls on the little finger. Later all o f the
fingers, and finally the whole hand, were involved. The whiteness
usually extends up to the metacarpophalangeal joint but sometimes
goes farther. His right hand never was affected this way until this
winter when the symptoms mentioned above occurred all at once




94

REPORTS OF PH YSICIAN S REPRESENTING TH E BUREAU.

and now symptoms are equally severe in both hands. When affected
the hands first get numb and a little later they become white and
when color returns in the fingers they are painful and sometimes ex­
tremely so. He compares this pain to the feeling which may occur
in a normal hand when it begins to get warm after it has been in
contact with snow or ice for some time.
The condition has been getting worse and on left side numbness
now not only involves the finger but also the ulnar side o f wrist and
ulnar half o f hand. No similar region is noted on the right hand.
When the hands get cold they are particularly weak and it is hard
to grasp and hold thii^s. They are weak nearly all the time but
especially so in cold weather. The trouble seems to come on more
readily in the morning. In the summer he does not suffer from these
symptoms but there is a certain degree of swelling in fingers and
hands.
Past history.—Measles, mumps, chicken pox, whooping cough, all
in childhood. Smallpox two or three months ago. Tonsilitis,
malaria, three or four years ago. No operations. No severe injuries.
Family history.—Father dead, pneumonia, cancer of face, 65
years of age. Mother dead, congestive chill, when patient was young.
Brothers, one living and well, none dead. Sisters, two living and
well, none dead. No tuberculosis, no insanity or nervous disturb­
ances. Father had cancer.
Marital history.—Married 13 years. One boy living. None dead.
Two miscarriages, at three months and four months. Lacerated
perineum from instrumental delivery of boy previously. No still­
births.
Venereal history.— Gonorrhea, 8 or 10 year$ ago. No luetic in­
fection.
Habits.— Tobacco— Pipe, cigarettes, cigars, about 20 a day; chews
a 5-cent plug a day. Alcohol—Never to excess. Coffee, tea, and
cocoa— Four or five cups a day. Appetite, fair.
GENERAL FEATURES.

H ea 4 — No headaches, no dizziness. Does not know of disturbance
o f eyesight. No glasses. No sore throats, but has frequent colds.
Hearing is slightly disturbed lately. Continuous ringing in ears.
No aching teeth.
Lungs.— Has a cough. No blood. No loss in weight. No fever.
Shortness o f breath on exertion— short winded. No edema. Pleurisy
two years ago.
Gastrointestinal.— Constipated. Habit of taking physics about
once a week or oftener. Occasional attacks of indigestion which
soda relieves. Burning in epigastrium. Dull griping pain, cramp-




REPORT OF PHYSICAL FINDINGS IN EIGHT STONECUTTERS.




95

96

REPORTS OF PH YSICIAN S REPRESENTING THE BUREAU.

like in character. When he gets hungry the pain increases. Eating
relieves. This occurs only once in a Avhile.
Genito-urinary.— No nocturnal urination. No burning or smart­
ing.
E X A M IN A T IO N .

Head.— Scalp— Negative.. Eyes— Pupils equal and round. Re­
act to light and accommodation. No nystagmus or strabismus. No
ptosis.1 Nose—No disturbance. Ears— No disturbance. Mouth—
Quite good. Tonsils not enlarged.
Neck.— No adenopathy—no pulsating veins. No thyroid enlarge­
ment.
Thorax.— Symmetrical. Lungs— Negative. Heart—Negative.
A bdomen.— Negative.
Reflexes.— Abdominal, present and equal; plantar, present, lively;;
cremasteric, present and equal. Elbow, wrist, ankle, knee, present
and equal. No Babinski. Idiomuscular reaction very marked.
Coordination.— No gross disturbance. Pupils 5 millimeters wide.
The hands were warm at the time when examination started. The.
skin on the fingers and in palm of hand was reddish but on the dorsal
surface of the hand the skin was of normal color. There did not.
exist any distinct decrease in sensation of pain, temperature and
touch. During the examination, however, the skin on the fingers,
became colder and the sensation to pain was not so acute as when
fingers were warm. The decrease in temperature of the skin occurred
although examination was conducted in a warm room.
After examination of sensation was finished hands were exposed,
to out-of-door temperature for a few minutes. The hands changed
markedly in their appearance. The fingers became white or bluish
white presenting the typical appearance of anemia spastica, and the
hand itself was of a bluish-red color. The sensation to touch, tem­
perature, and pain in the fingers was now much diminished.




1 C om plete or p a rtia l drooping o f the upper eyelid.

REPORT ON EIGHT CASES AT CAMP SHELBY, MISS.
B Y M A J . N . A . CARY, MEDICAL CORPS.

I have personally investigated the physical condition of eight
enlisted men of the One hundred and thirty-ninth Field Artillery
who have had from 4 to 14 years’ experience in stonecutting in
Bedford, Ind., and other quarries, and the data collected in each
individual case are as follows:
No. 1 gives history of stonecutting of seven years. He has had
no experience with the -pneumatic hammer. No physical defects
were found.
No. 2 has had seven years’ experience as stonecutter. Three years
o f this time he used the pneumatic hammer. Case complains of
numbness in all fingers, bilateral, with pain in the arms, bilateral.
The numbness and tingling is most marked on cold gind damp days
and after taking shower baths. He complains of being nervous, has
a slight insomnia, ringing in the ears, which condition has not im­
proved since entering service. There is a profuse sweating of hands
and forearms that he states is present both day and night. He has
a slight tremor at present, has gained 10 pounds in weight since
entering the service and his appearance is that of a well-nourished
man. The numbness complained of does, not seem to interfere with
movement, and his ability to handle the piece (rifle) is'not inter­
fered with. He states that he is unable to restore a normal feeling
in the hands and arms by artificial heat, but by calisthenics the
feeling is restored in five to six minutes. I personally observed the
hands of this man on a cold morning and found that the fingers
were markedly cyanosed, the finger nails were quite blue, and by the
use of a pin feeling was demonstrated to be absent.
No. 3 has had 12 years’ experience as stonecutter and 10 years’ use
of the pneumatic hammer. He complains of dull, dead feeling in
fingers and forearm of left hand on cold mornings, also first finger of
right hand. Movement of fingers is markedly interfered with on cold
mornings. He is unable to button his clothing or to hold shoestring
in lacing shoes. He notices no interference with handling piece
while at gun drill, but says piece feels bundlesome because he is un18476°— Bull. 236— 18------ 7
97




98

REPORTS OF PHYSICIANS REPRESENTING THE BUREAU.

able to get proper feeling in his fingers. He says heat will not warm
fingers and hand,*- but *that it requires movement for six to seven
minutes to restore proper feeling. I f gloves are placed on the
hands while numbness is present the hands remain in this condition
for hours without change. He has made no gain in weight since
entering service and says there is no improvement in his condition
since entering service. He has a hacking cough that he has had for
the past 4 years. Physical examination shows cyanosis of fingers
in left hand and lower part of left forearm. His finger nails are
blue and partial anesthesia is present.
No. 4 has had four years’ experience as stonecutter and four years’
use of the pneumatic hammer. He complains that on cold mornings
the first and second joints of the fingers of the left hand have a pecul­
iar dull, dead feeling. He has never noticed any interference with
handling o f the piece at gun drill, and gives practically the same
history as No. 3 relative to hands remaining dead unless exercised.
Physical examination shows cyanosis of proximal phalanx, first and
second fingers; left hand shows partial anesthesia present.
No. 5 has had six years’ experience as stonecutter, two years’ use
of pneumatic hammer. He has a slight numbness in little finger of
his right hand, which is most marked on cold days. He has no other
symptoms. He has gained 10 pounds in weight since entering the
service. Physical examination shows slightly cyanosed little finger
o f right hand, and no anesthesia.
No. 6 has had seven years’ experience as a stonecutter, three years
with pneumatic hammer. He complains of a numbness in the four
fingers of the left hand (he is right-handed), and this is increased
on cold days to the point o f pain and marked discoloration in fingers.
He has no stiffness. He has gained 14 pounds in weight since enter­
ing the service. There is no interference with his movements while
at drill after he has exercised sufficiently to get fingers warm. Physi­
cal examination showT no cyanosis and no anesthesia.
ed
No. 7 has had eight years’ experience as a stonecutter and eight
years’ use of pneumatic hammer. He complains that the second,
third, and fourth fingers of the left hand constantly have a peculiar,
dull feeling w hich is more marked on cold days. He has noticed
T
this condition for the past seven years and believes it is due to the
gripping of the chisel, and the vibration of the pneumatic hammer;
he especially complains that the hand and forearm develop this dull,
numb feeling if he sleeps with his arms above his head. He says
there has been marked improvement since coming into Federal serv­
ice and there is no interference with movements while at gun drill
after his hands become thoroughly warm. There is a slight inter­
ference with movement previous, however.




REPORT ON EIGHT CASES AT CAMP SHELBY, MISS.

99

No. 8 has had 14 years’ experiei^ee as a stonecutter, eight years
with pneumatic hammer. He complains of botli hands becoming
numb, more especially across the fingers on cold mornings. No such
condition present on warm days. He says his movements are inter­
fered with to a marked extent, and that he has dropped the piece
while at gun drill because of the numbness. He has warm gloves
but they do not warm the fingers and the only method by which he
can restore a normal feeling in these fingers is by exercises, more
especially finger exercises. There is no swelling and no discoloration
normally, but on cold days, as I observed him, the fingers are mark­
edly cyanosed with a marked partial anesthesia present.




REPORTS OF PHYSICIANS OF THE PUBLIC HEALTH
SERVICE.
HEALTH HAZARDS FROM THE USE OF THE AIR HAMMER IN
CUTTING INDIANA LIMESTONE.
B Y J. P. LEAK E, PASSED AS SIST A N T SURGEON, UNITED STATES PUBLIC H EA LT H
SERVICE.

Indiana limestone from the vicinity of Bedford, Ind., is at present
the most important building stone in America. Beside its archi­
tectural qualities, its value is due largely to the ease with which it
can be quarried and worked in large quantities. It is of fine texture,
of the class called oolitic because of the small egg-like fossils of
which it is. composed, of even consistency, and comparatively soft to
the tool.
The center o f the industry is Bedford, a city of 10,000 population,
the county seat of Lawrence County; Bloomington, a city of abput
the same size, the county seat of Monroe County, adjoining Lawrence
County on the north, is next in importance as a stone center; Elletts­
ville and Stinesville, north of Bloomington, are smaller centers.
Bedford has railroad shops and other small factories, but it is essen­
tially a town of one industry—stone—while Bloomington is the seat
of the State university and enjoys more varied activities.
There are 39 stone companies in the district. Though some of
these engage in both branches of the work, a sharp line is drawn
between the production of rough or machine-tooled stone and the
production of dressed or cut stone. It is only the latter with which
this investigation is concerned.
The greater part of the quarrying for Bedford is near Oolitic, a
town of about a thousand inhabitants, 4 miles northwest of Bedford.
For all but the preliminary squaring off of the blocks (the process
called scabbling) the stone is brought to the mills in Bedford. These
mills are very large buildings, some operating 7-ton or 15-ton
electric cranes and containing tracks for the loading and unloading
o f freight cars. On account of their size and height, and the wide
doors, they are difficult to heat; moreover, they contain no intrinsic
source o f heat, such as the furnaces of a steel mill.
In general, the blocks of stone from the quarries are first sawed
into large slabs by reciprocating gang saws. These are strips of
steel without teeth, the abrasion being furnished by a mixture of
100




H EALTH HAZARDS FROM USE OF AIR HAM M ER.

101

sand and water, which is fed from above. Next, the slabs may be
sawed by large circular saws with black Brazilian diamond teeth.
This is also a wet process; the spray is largely gathered by the hoods
over the circular saws. I f the stone is not to be cut by hand, machine
dressing follows next; steel cutting instruments are used on the
planers, circular planers, and lathes without further moistening of
the stone. In the planing machine the block of stone reciprocates on
a bed beneath the tool, which takes off one layer after another in a
coarse powder, producing fluting and other straight line figures
which were formerly cut by hand.
The stonecutting (hand cutting) is usually done at one side of the
main craneways, and, as observed at the time of this investigation,
the air hammer was almost entirely employed for this work, except
in the case o f the apprentices, who are required to use the mallet in
the old-fashioned way. This work, whether plain cutting or carving
more intricate figures, such as statuary and Corinthian capitals, is
done in two parts, called* “ roughing out ” and “ cleaning up.” In
“ roughing ou t” the block of stone is roughly shaped to the form
which it is finally to assume, and the steel hand hammer or wooden
mallet is occasionally used to deliver the impacts; this part of the
work is less exacting and less time-consuming than the finishing or
“ cleaning up ” for which the pneumatic hammers appear to be used
exclusively by the journeyman cutter. But the division between
“ roughing out” and “ cleaning up,” as that between plain stonecut­
ting and carving, is not a sharp one.
There are normally 200 or 300 stonecutters in Bedford, 50 to 75
in Bloomington, and smaller numbers in Ellettsville and Stinesville.
On account of inactivity in stone construction, much smaller numbers
were found employed, and the employment varied frofn day to day.
In general, however, the employment has been fairly steady and
permanent; the stonecutters are a superior class of workmen, many
owning excellent homes. Their hours of labor are strictly limited to
8 per day and 4 on Saturday, 44 hours a week. The wages at the
time of the investigation were 67^ cents an hour. The carvers are
not hired directly by the mills, but this work is let to subcontractors,
who employ other carvers, by the hour, to help them.
In the stone industry, pneumatic tools were probably first used on
granites and the harder stones. The first air hammer was introduced
in Bedford about 22 years ago, and use of these hammers became
universal in this district' about 7 years ago. The air compression is
maintained by steam air pumps and tanks at about 85 pounds per
square inch, and is piped to the place of carving. Flexible pressure
hose connects the air pipes with the hammer; the air is turned on for
each hammer by a thumb cock in the rubber hose about 3 feet from
the hammer. Various makes and sizes of pneumatic hammers were




102

REPORTS OF PHYSICIANS OF PUBLIC HEALTH SERVICE.

seen. The reciprocating strokes are produced by the piston alter­
nately opening and closing inlet and exhaust openings at various
points on the interior of the cylinder (piston valve) and thus re­
sponding to the force of the air pressure.
i
The tool is not attached to the hammer, but must be held in the
point of the hammer by the hand. The tools are about 10 inches
long, including a butt of about 1^ inches which fits into the hammer.
The diameter is variable, frequently about half an inch, giving a
weight of about 9 ounces. '
The dimensions of two hammers frequently used are approximately
as follow s:
Three-quarter inch.
Total length.....................................................................
Total weight (without tool)............................................
Outside diameter.............................................................
Inside diameter...............................................................
Inside length (cylinder)....................... 1.........................
Length of stroke............................................................
Diameter of piston......................... . ...............................

6.7 inches...................
If pounds...................
1.2 inches...................
| inch.............
2.6 inches....................
0.9 inch..................... .
| inch.........................

1 inch.
8 inches.
3f pounds.
1.6 inches.
1 inch.
2.8 inches.
1.07 inches.
1 inch.

Length of piston proper................................................................ 1.7 inches......................... 1.73 inches.
Length of piston rod (for impact against tool)..................... 0.9 inch............................. 1.5 inches.
Weight of piston (with rod)...................................... ..... ........... ’ 6 ou nces......................... 3 ounces.

By means of a tuning-fork mechanism the rate of vibration of
various tools was measured.1 The apparatus consisted simply of
a copper platen attached by an adjustable clamp to the tool whose
vibration was to be measured. The platen was smoked after being
fixed to the tool, by movifig it over a bit of ignited camphor. While
the tool was being used on a piece of stone, a tuning fork, with trac­
ing point attached, was drawn rapidly across the platen. I f the tool
were not vibrating, the resulting curve would show merely the smooth
vibrations o f the tuning fork. I f the tool vibrated at the same time,
the compound curve would .show a certain number of the smooth
tuning-fork vibrations and also the sharp strokes of the tool, giving
peaks different in shape, height, and number from those caused by
the tuning fork. The ratio of the number of the former peaks to the
number of the latter in a given distance on the tracing gives the
rate of vibration of the tool when that of the fork is known.
Various hammers, even of the same size and type, and with the
same registered air pressure, were found to give rather widely vary­
ing rates of vibration, dependent apparently on the pressure exerted
by the stonecutter against the stone and on the lubrication and
amount of wear of the hammer. It was soon found that with a range
o f tuning forks the rate of vibration could be gauged fairly accu­
rately by comparing the pitch of the main note given by the vibrating
1
T h e w riter is indebted to P ro f. A . L. F o ley o f the D ep artm en t o f P h ysics, Ind ian a
U n iv ersity , fo r su g gestin g and perfectin g the d eta ils o f th is ap paratu s.
I t is sim ple
and appeared to be th e m ost accurate o f several w hich w ere considered.




H EALTH HAZARDS FROM USE OP AIR HAMM ER.

103

tool with that of the tuning fork corresponding most ck>sely to it.
However, especially when forks with low amplitude o f vibration were
used, it was found that accessory vibrations of the tool, sometimes
two or three times as frequent as the main vibrations, were recorded
on the platen; these were presumably caused by the elasticity of
the stone and steel, the tool reverberating between the stone and
hammer after each stroke of the piston. With 85 pounds’ pressure,
the 1-inch hammer gave a main vibration rate varying between 88
and 136 per second (5,000 to 8,000 per minute), and the threefourths-inch up to 167 per second (10,000 per minute). This is
much more rapid than the figures usually given, and still does not
take account of the more rapid accessory vibrations.
The hammer itself is held by a right-handed person in the right
hand, between the thumb and forefingers in much the same way as
a pencil or pen is held. Some of the stonecutters regulate the power
of the stroke by holding the thumb or forefinger over the exhaust.
This may create a callus or a small area of insensibility at times, but
does not appear to be productive of any serious results. The tool
is held in the left hand, the most powerful part of the grasp and
that controlling the direction of the cutting edge being exerted by
the ulnar part of the hand. The direction of the hammer and tool
is diagonal to the surface of the stone, and the rotation of the chisel
{ about its own axis as well as the depth of the cut must be controlled
very accurately. Since the tool is slender and rotates freely in the
hammer, this necessitates a very firm and constant grip with the
left hand. These points are important, as will be shown later.
Some of the air hammers, presumably those which were considerably
worn, were observed to discharge air along the piston rod and tool,
against the fingers of the hand which held the tool. This was not
observed to cause serious discomfort, but may have interfered with
the power of the stroke.
The work is fairly continuous. Frequent changes of position and
interruptions to blow away dust, make measurements, and change
’ tools occur, but the hammer is in the hand and operating for the
greater part of the time. Competition in speed, in part stimulated
by the foremen or subcontractors, in part natural to the stonecutters,
is probably keener than in smaller shops under the old conditions of
stonecutting; in Bedford, stonecutting has been transformed to a
factory occupation.
Heat was furnished in one of three ways: First, by hot-air conduits
opening in the vicinity of the stonecutters; second, by steam pipes
around the side of the building; third, by coke-burning salamander.
O f these the third appeared to be the most efficient, and the mills are
so open that danger from carbon monoxide poisoning was minimal.
Howeverj since cold appears to be a factor in the production of dis-




104

REPORTS OF PHYSICIANS OF PUBLIC HEALTH SERVICE.

comfort from the use of the tool, it would be advisable to install
radiators, or other devices for heating the tools and the hands on cold
mornings, in closer proximity to the cutters than the hot-air conduits
and; the steam pipes. The temperature in the mills is much less
severe than in the open sheds where stonecutting has customarily been
done. In one mill where the outside temperature was 16° F. at 7.30
a.m., the temperature where the stonecutting took place was ob­
served to be 36° F. at the same time. In another mill the inside tem­
perature was 40° F. when the outside temperature was 22° F .; in a
third the inside temperature was 40° F. when the outside tempera­
ture was 26° F. In two metal plants where pneumatic tools were
being used the temperatures were 45° F. and 62° F. when the outside
temperatures were 19° F. and 21° F., respectively.
As regards lighting, conditions were satisfactory. The stonecut­
ting is usually done at one side of the mill and therefore near
windows.
OTHER USES OF VIBRATING PNEUMATIC TOOLS.

The use of pneumatic tools was also observed and tried in drilling
holes in limestone, in cutting granite and other hard stone, in rivet­
ing metal plates, in calking boilers, in chipping castings, in cutting
metal preparatory to calking, and in cutting grooves on sheet metal.
In the mills and at the quarries, reciprocating pneumatic drills;
called “ plug drills,” are used for drilling holes in the blocks of stone
•for hoisting and for, breaking. These drills are much larger than the
air hammers used in stonecutting, especially in length of stroke, and
the rate of vibration is much slower. The hammer has a pistol or
shovel grip, and the tool, or drill proper, is guided by the left hand
only at the first application to the stone; when the hole has been
started both hands grasp the hammer. Moreover, the drill is of larger
diameter than the tool in stonecutting, and the grasp does not need
to be so rigid or to direct the point so accurately as in the latter work.
In granite and monument cutting, the air hammer and-tools are .
like those used in the Indiana limestone belt. Part of the granite
cutting, however, is a pulverization of the stone, with the hammer
and tool held perpendicular to the surface. It is apparent that when
the work is of this character the grip on the tool is not of necessity
as firm as when diagonal cutting is done. The main vibratory rates
and the accessory vibrations were found to be similar to those in the
limestone mills. The tendency toward vasomotor spasticity in the
left hand (to be described later) was observed in the granite cutters,
but not so uniformly nor to so marked a degree as in the limestone
cutters.
In hot riveting outdoors and in hot and cold riveting in shops and
mills the largest hand air hammers are used, those with pistons 1 ^ -




HEALTH HAZARDS FROM USE OF AIR HAM M ER.

103

inch diameter and a 9-inch stroke being a common size. These give
about 20 vibrations per second. Here both hands r
are on the hammer,
which usually has a pistol g rip ; the cap or “ set ” which hits the rivet
is-altached to the hammer by a spring clutch and does not need to be
held. Eiveting by sledge hammer was also observed; a rivet is
headed as quickly by this method as by the use of the pneumatic
hammer, but the strain on the men is much more severe. No cases
o f vasomotor spasticity were discovered among pneumatic rivet men.
In calking metal seams, a smaller hammer is used than in riveting,
and the calking tool is held in the hand, but a firm, rigid grasp is
not necessary, as the action of the hammer is perpendicular to the
surface and the tool guides itself to a large extent.
The chipping preparatory to this calking, on the contrary, is
inclined work. A triangular ribbon of steel is cut from the upper
plate in order to make a bevel for calking. Grooving a sheet of
metal is a somewhat similar process. Not so much attention, how­
ever, is directed in these cases to make the finished job smooth in
appearance as in stonecutting, and the grasp on the tool is conse­
quently not so rigid or continuous. The vibration rate is about 50
per second.
, Chipping rough projections from castings is like the processes just
described, but frequently larger hammers are used. Some of the
tools used for this purpose have a hexagonal butt which fits into a
six-sided opening in the end of the hammer snugly enough to prevent
turning, but allowing free up and down motion. With the pistol grip,
which is almost universal in pneumatic hammers for metal work, this
enables the operator to guide the tool well with the hammer hand,*
and to relax the grasp on the tool to some extent. None of the metal
workers who used air hammers admitted the blanching of the hands
which was found so frequently in limestone cutters.
It is thus seen that in these other uses of the pneumatic hammer
(except granite cutting, which is somewhat similar to limestone
cutting) the rate of vibration is slower and the grasp on the tool less
constrained and constant than in the occupation under consideration.
We should therefore expect that if the vibration itself had any dele­
terious effect, this would be at a maximum in the case of the stone­
cutters.
THE PULMONARY HAZARD.

Though this investigation was primarily directed to ascertain the
possible effects of the air hammer in producing nervous disorders, it
was deemed worth while to secure some data on the pulmonary haz­
ard, since dust is commonly supposed to be the one great danger in
the stonecutting trade. The infiltration of the lung with dust par­
ticles is known as pneumokoniosis, in the case of stone dust, as chali-




106

REPORTS OF PHYSICIANS OF PUBLIC HEALTH SERVICE.

cosis; the result is a fibroid phthisis giving rise to dyspnoea, less often
to cough and expectoration, at times fatal in itself, but more com­
monly found at necropsy when the direct cause of death has been
tuberculosis. We may therefore consider the dust as predisposing to
pulmonary infection with tubercle bacilli—less often with pneumo­
cocci or other organisms—and we may expect to find chalicosis ex­
pressed in the death records as pulmonary tuberculosis.
All prior statistics based on this assumption class stonecutting as
a somewhat hazardous occupation. In this country the census of
19001 recorded 33 per cent of the deaths among marble and stone
cutters as due to pulmonary tuberculosis, while for all occupations
(males) the percentage was only 14.5. In 19092 28.6 per cent of
marble and stone cutters, 14.8 per cent of all occupied males, and
21 per cent of all occupied females who died, died of pulmonary tu­
berculosis. Hoffman3 has reported the experience of the Prudential
Life Insurance Co., 1907-1910: 47.8 per cent of the deaths among
stone workers 25 to 44 years of age and 32.3 per cent of those 45 to 64
years of age were due to tuberculosis; among all occupied males the
percentages for the two age groups were 38.5 and 14.1, respectively.
Through the courtesy of the officers o f the Journeymen Stone
Cutters’ Association of North America, part of the death records of
this organization were summarized. O f 343 deaths among stone­
cutters with assigned cause, 56 per cent were credited to pulmonary
tuberculosis, stonecutter’s consumption, and fibroid phthisis. On
every count, then, stonecutters have suffered severely from chronic
pulmonary disease, presumably caused by the stone dust.
# I am indebted to Dr. Harvey Voyles, registrar of Bedford, for
access to the original mortality' records of that city, which are in
good shape for the past 10 years, except for some uncertainty (as is
common in death records) as to stillbirths; on this latter account
only persons over 1 year of age were considered. To secure a basis
for comparison, the United States Mortality Records were similarly
summarized for 1910-1915, the middle six years o f the past decade,
since the records for 1916 and 1917 are not available. For the regis­
tration area, 11.3 per cent of all deaths in this age group (11.9 per
cent in males, 10.5 per cent in females) were due to tuberculosis of
the lungs, for Indiana 11.5 per cent. For Lawrence County, Ind.,
12.6 per cent of deaths at all ages were due to pulmonary tuber­
culosis; for the registration area 9.4 per cent at all ages, and for
Indiana either as a whole or disregarding cities of over 10,000 popu­
1Twelfth Census of the United States. Vital Statistics, Part 1, Tahle 8, p. 154. Wash­
ington : United States Census Office, 1902.
2 Mortality Statistics, 1909. Tenth Annual Report. Table VIII, pp. 388, 402. Wash­
ington : Government Printing Office, 1912.
8 Hoffman, F. L». Exhibits of the Prudential Insurance Co. of America. International
Congress on Hygiene and Demography. Pp. 24, 29. Washington, 1912.




H EALTH HAZARDS FROM USE OF AIR H AMM ER. '

107

lation in 1910, 9.9 per cent. The population of Bedford was 8,716 at
the last census. The tuberculosis proportional rate in Lawrence
County is thus seen to be above normal. But beside Bedford and
the limestone mills, Lawrence County contains the town of Mitchell,
near which are large cement factories. Cement works are notoriously
dusty, and both locally and nationally have a reputation for high
consumptive rates. The death rate per thousand from pulmonary
tuberculosis in the registration area for the six-year period was 1.31,
in Indiana 1.29, in rural Indiana including all of Lawrence County
1.24, in Lawrence County 1.60.
Among stonecutters in Bedford 15 per cent of the deaths during
the 10 years were due to pulmonary tuberculosis. Among all the
workers in the stone mills, including the planer men, 12 per cent of
the deaths were assigned to this cause. No disproportionately high
number of deaths was assigned to other respiratory or heart diseases,
under which titles might be found fatalities really due to chalicosis.
Among all other males o f the same age group (23 to 72 years) the
proportional rate was 13 per cent; among all females 21 per cent;
among all persons over 1 year of age the proportional rate (from
tuberculosis of the lungs) was 13.3 per cent, corresponding to 11.3
per cent for the registration area.
Objections might be raised to conclusions from these statistics in
that for some items there were only a small number of deaths; also
that the age groups were very broad and that proportionate per­
centages instead of actual death rates were compared. In regard to
the small size of the items, it is to be noted that the classes are not
subject to the allowances made for samples, but that they represent
the total number of deaths. The age distribution was not strikingly
dissimilar in the different classes. The possibility of consumptive
stonecutters having left the trade or sought other climates is to be
considered, but the higher percentage of tuberculosis in Bedford
among females than among males would argue against the assump­
tion; for if the affected stonecutters had left the trade, while still
remaining in Bedford, we should expect a disproportionately high
rate among the males of that age group as compared with the sex
which is not subject to the hazard.
It accordingly appears that while Bedford has a proportional
death percentage from phthisis slightly above normal, it has been
no ^higher for stoneworkers than for other classes of the population,
including females.
This agrees with what could be learned from a canvass of the
physicians o f Bedford and from the stonecutters themselves. The
only case of consumption in stonecutters about which information
could be obtained in this way was in a man who developed the disease
nursing his wife through a fatal tuberculosis. No X-ray chest plates




108

REPORTS OP PHYSICIANS OF PUBLIC HEALTH SERVICE.

were made, but in examining the man no symptom or sign which
could be attributed to pneumokoniosis was found.
The mills were not as dusty as several granite monument shops
which were visited, but the difference was not striking, except for
the fact that in the monument shops the dust was in the air, while
in the limestone mills the dust was almost entirely on surfaces.
There are at least four conceivable explanations for the comparative
immunity of the Bedford stonecutters: (1.) The particles may be
larger and heavier than in the cutting of other stones; as one looked
down the stonecutting aisles of these mills the visible cloud of dust
from each tool stopped far below the face of the worker. In general
the exhaust from the pneumatic tool blows what dust is formed away
from the breathing zone. In limestone cutting the action of the tool
is chipping at an acute angle with the surface of the stone; as ex­
plained before, in granite cutting the action is frequently perpen­
dicular to the surface and possibly more pulverizing. (2.) The
blocks of stone as they reach the cutter in the mills, though not
visibly wet, retain some of the moisture from the sawing processes.
This reduces the dustiness of the cutting. (3.) It is possible that the
particles from the oolitic limestone are rounder and smoother than
those from other stones; an accurate microscopical comparison was
not made. (4.) By some theories, calcium salts have a beneficial
action in tuberculosis, aiding in walling off chance lesions from fur­
ther activity. In general, the cutting of limestone has been held to
be less perilous than the cutting of sandstone or granite. In any
case, stonecutters appear to suffer less in Bedford than elsewhere
from the dust hazard.
Associated with the dust hazard is the hazard from flying chips,
largely an ocular one. Only a small proportion of the men were
observed to wear protecting goggles. But on account of the inclina­
tion of the hammer J:he direction of the chipping is away from the
worker’s eyes. The physicians and oculists in Bedford state that
while eye injuries occur in the stone mills, the most numerous and
severe are not among the workmen who handle the stone, but among
the metal workers, machinists and tool sharpeners; stone particles
rarely cause more than temporary injury.
THE NERVOUS HAZARD.

At the outset of the investigation it was observed that the stone­
cutters on cold mornings were likely to have the fingers and ulnar
side of the left hand white, cold, and numb. The investigation was
primarily directed toward ascertaining the seriousness o f this condi­
tion and whether other nervous troubles might be attributable to the
use of the air hammer. The general findings and conclusions in this




HEALTH HAZARDS FROM USE OF AIR H AMM ER.

3
109

regard are given in Prof. Edsall’s report. The writer is deeply in­
debted to Dr. Edsall for advice and collaboration, and for making by
Jar the greater part of the more thorough examinations.
< Many have considered the action of pneumatic tools to be unduly
fatiguing or to subject the nervous system to some mysterious injury,
but no data have been available sufficient to draw conclusions in the
matter. Southard and Solomon1 have reported a case of pain and
numbness in the hand of a granite cutter, in whom they found a
slight anesthesia demonstrable only by Martin’s electrical sensory
test. This cutter had used a pneumatic tube for 15 years; the Wassermann reaction was positive. In this investigation it was felt that
changes in sensation perceptible to the examiner only by use of a
faradic current and not by any of the ordinary tests or by functional
ability, in the first place must be very slight, and in the second place,
especially in the question of occupational neurosis, might be rather
dubious.
The following form was used to record the histories obtained at the
time of examination:
Name______________'_________ Residence___________________
Age______________
Years with air hammer____ Years with mallet____ Type hammer used____
Stone____ Character of work (roughing, finishing, ca rvin g )__________________
W here_______________ Finger complaint_____________ Location_______________
When first noticed_____________
(Underline condition observed at examination.)
Other complaints:
Sleep_______ Pain_______ Numbness_______ Cold_______ Breath_______
Exhaust control__________________________ Along tool__________________________
Opinion as to best form o f hammer and character o f w ork___________ __________
Date examined_____________ H our________________
Location_________________
Temperature outside__________
Temperature where examined________________

Besides the 19 men examined by Dr. Edsall, three other cases were
examined in detail because they were commonly reported to be
among the most severe sufferers from the use of the air hammer.
Two were said to have stopped stonecutting on this account, and had
left the Bedford district. In none of the three was there evidence
of any organic change of consequence which could be attributed to
the hammer. On the right forefinger of one man there was an area
of diminished temperature sense; this was the finger used in con'trolling the exhaust. Calluses interfered with pain and touch sen­
sitiveness over p^irt of the hands, and when the parts were cold all
sensibility was obtunded, but not more in any of the three cases than
was the case with the hands of the examiner.
Of those who had changed their employment supposedly on ac­
count of objections to the air hammer, one stated that he quit be­
1 Southard, E. E., and Solomon, H. C .: Occupation Neurosis, p. 288 in Kober & Hanson’s
Diseases of Occupation and Vocational Hygiene. Philadelphia, 1916.




110

REPORTS OF PHYSICIAN'S OF PUBLIC H EALTH SERVICE.

cause he had a disagreement with the foreman about another matter,
a second had sought easier and steadier work, but found that two
years o f indoor occupation made him more nervous than cutting
stone with the air hammer. A third had been badly frightened *by
hearing a severe prognosis made as to the possible effects o f the
hammer; he was habitually nervous and apprehensive in using the
pneumatic tool, but stated voluntarily that he would like to go
back if it were improved so as to relieve the strain.
When the stone mills were visited soon after work started in the
morning the greater part of the cutters and carvers showed a blanch­
ing of the ulnar part of the hand which held the tool, with numbness
and lowered temperature. They stated that this occurred com­
monly, but not uniformly in any one subject, in winter and on cold,
damp, spring mornings. It also occurred frequently when the hands
were subjected to cold in any way. It could be brought out in
many of the men weeks or months after they had stopped work by
plunging the hands for a few moments into snow or cold water.
The hands of the examiner, used as a control, would under these cir­
cumstances show the normal hyperemic reaction, as did also the right
hands of the stonecutters usually. On the left hand, typically, the
little finger and hyperthenar eminence, the ring finger, and the tip
of the middle finger became white and nearly bloodless. This might
involve other fingers and the palm of the hand. I f the person were
left-handed, the right hand would show the phenomenon.
Designating the digits as 1, 2, 3, 4, 5, in order from the thumb to
the little finger, the following table indicates the distribution of this
vasomotor hypertonicity as to the fingers affected:
DISTRIBUTION OF BLANCHING, BY FINGERS.

Case.

1

............................................

3
. 4
5
ti

............................................
................................................
............................
............................................

2

...............................

8
....................................
(i
............................
10
It ................................................
I1
....................................
13 .......................................... ...........
1
1
........................................ •
. . .
_ ........
_
t o ..................................................
17 .................................... ...........
1« ........................................ .........

.....................

20
. . . . .
21....................................................




Tool
hand.

Hammer
hand.

..........

5
5
5
5
4.5
4.5
4.5
4.5
4.5
2,3,4
3.4.5
3.4.5
3.4 .5
3 .4 .5
3 .4.5
5 .4 .5
3.4.5
3 .4 .5
3.4.5
3 .4 .5
3.4.5
3 .4 .5 .......................

Case.

22............ ............... ......................
23....................................................
24........................................1.........
25....................................................
26.................... ...............................
27....................................................
28....................................................
29....................................................
30....................................................
31....................................................
32....................................................
33....................................................
34....................................................
35....................................................
36............................ .......................
37....................................................
38.............. .....................................

4 iiiiiin r iiiiiiiiiiiiiiiiii
o

41....................................................
42 ............................. ............ ............

i kittle finger held under tool.

Tool
hand.

3 .4 .5
3.4.5
3 .4.5
3 .4.5
3 .4 .5
1 2,3,4
5 .4 .5
2.3.4, 5
2.3.4 , 5
2. 3, 4, 5
2 .3 .4 .5
2 .3 .4 .5
a, a, , 5
. .
. ,2 .3 .4 .5
2 .3 .4 .5
1 .2 .3 .4 .5
1 .2 .3 .4 .5
1 .2 .3 .4 .5
W
#4 ,5

4
2 3 1.5
2 3 4,5

Hammer
hand.

2
2
3
2,3

2
2
1
2

HEALTH HAZARDS FROM USE OF AIR H AM M ER.

I ll

. The greater number of the cutters showed the condition on the
cold winter mornings during which the investigation was in prog­
ress—in one mill 5 out of 6, in other mills 6 out of 7, 2 out of 4, 4 out
of 7, 8 out of 11, and 5 out of 7. Usually, decided discomfort was ex­
perienced when the blood returned to the hand, but the work was not
seriously interfered with. The apprentices, who did not use the air
hammer, had colder left hands than right, but no clear history was
obtained of the typical reaction in its marked form in men who used
the mallet exclusively. A former boiler builder, now one of the
sales force for the boiler factory, who never used a pneumatic tool
and had not heard of the above condition, described the same phe­
nomenon as occurring in his left hand, following the use of hand
tools in the boiler shop.
It is noteworthy that many of the older stonecutters state that
they formerly had trouble of this sort, but do not have it at present.
It is their belief that {he younger workmen grip the tool too tightly.
This spastic anemia, however, was sluggish in onset, taking months
or more than a year for full development, and lasting equally long
after the cause was removed; it occurred only irf cold weather, and
not continuously then. In spite of thorough seareh for the worst
e^ses in and out of Bedford, no suggestion of any more severe
changes than those described was obtained. There seemed no ten­
dency for the anemia to go on to frostbite or necrosis. The use of
gloves did not prevent the blanching.
Other nervous symptoms encountered bore more or less relation
to the hand phenomenon. Sleep was disturbed in some cases by
the hands and arms becoming numb very readily. Pains, par­
ticularly confined to the left side and extremities were occasionally
described* but did not appear to be more severe than would be
encountered among groups o f workmen of the same age and habits
who did not use pneumatic tools. Those unaccustomed to the air
hammer unquestionably suffered more severely from these functional
nervous symptoms. A few minutes’ early morning use of the hammer
in cutting stone (longer than a momentary trial) gave the writer an
unpleasant, cramped, slightly painful sensation in the fifth digit
and the ulnar side of the left hand, during the entire evening, with
observable redness and swelling. The phenomenon was noticed
before the use of the hammer was recalled. Recovery was complete
over night. The factors concerned were evidently similar to the
ordinary local fatigue and strain such as are commonly experienced
from an unaccustomed employment. This is in agreement with
the frequent statement of the stonecutters that their chief difficulty
as regards nervousness and sleeplessness was when they began to use
the tool, but that as they became used to cutting stone with the air
hammer these symptoms wore off. The development of the white




112

REPORTS OF PHYSICIANS OF PUBLIC H EALTH SERVICE.

fingers, however, is said to be more gradual, coming on in the winter
after the pneumatic tool had been in use for some months.
It appears, then* that the continued use of the air hammer in cut­
ting limestone leads to a disorder shown by a blanching o f parts o f
the left hand, with cold and numbness; that this is not a serious
disease, but in some cases decidedly disagreeable, and that measures
should be instituted to prevent it. O f the three assigned causes,
cold would appear to be merely the exciting cause. It would never­
theless be advisable to provide radiators or other means of heating
the hands and tools of the stonecutters, giving a source of heat nearer
to the working places than the present pipes and hot-air conduits.
O f the two other factors, the strain caused by the cramped position
o f the hand in grasping the narrow tool, and the vibration, the former
would appear to be dominant, but the vibration can not be eliminated
as a cause since the phenomenon apparently does not occur in metal
workers who use hammers with much lowx vibratory rates, but who
er
nevertheless guide the tool in somewhat the same way as do the
stonecutters. The sensation imparted to the hand by the slower
vibration is very different from that felt in the use of the air hammer
in the stone works.
It has been suggested that changes along one o.r more of the four
lines indicated below might be effective, but the problem is essen­
tially a mechanical one, the object being to make the grasp of the
left hand more comfortable and less straining, and also if possible to
relieve some of the vibration received by that hand. Until an ef­
fective method is in use, it is advised that there be periods of rest
from the use of the hammer and narrow tool, to enable the muscles of
the left hand to relax and change their position.
1. A tool of larger diameter would permit a more hygienic grasp.
It is possible that due to the softness of the stone and the necessary
accurateness of the work, the impact of a light tool is preferable to
that of a heavy one, but it w ould appear that if pressed against the
T
stone, it is the construction of the hammer and the air pressure which
determine the impact rather than the weight of the tool. A heavy
tool, moreover, would reduce the vibratory effect felt by the left hand.
2. The shank of the tool might be provided with a tight fitting
cover of asbestos or other similar material. This would need to be
very rigid in order to permit proper guiding of the tool.
3. Instead o f a tight handle, as above, a handle permitting recip­
rocal but no rotary motion could be used.
4. The end of the hammer might be prolonged over the tool so that
the left hand in guiding grasps this instead of the tool. The tool
should then have a square or hexagonal shank or be provided with
grooves to prevent any rotary motion, and should also have a spring
catch such as the rivet set in a pneumatic riveter.




H EALTH HAZARDS FROM USE OF AIR H AM M ER.

113

CONCLUSIONS*

1. The pulmonary hazard is much less in stonecutting in the Bed­
ford plants than in stonecutting in general. This is unquestionably
the great hazard in the trade and its relative absence in this center
makes the occupation of a stonecutter here more healthful than else­
where. The workmen are not exposed to severe weather, the work­
rooms are large and well ventilated. In some of the mills the sani­
tary conveniences and guards against the spread of intestinal infec­
tion are satisfactory, but in others improvements should be made.
2. There exists in the hands of stonecutters who use pneumatic
hammers a hypertonicity of the blood vessels which shows itself as
an exaggerated reaction to low temperatures.
This is not serious as to life or function, but is uncomfortable at
times, and should be remedied. It is believed that this can be done
without eliminating the tool, and suggestions are made to that end.
18476°—Bull. 236—18----- 8




REPORT TO SURG. GEN. BLUE ON THE SUPPOSED PHYSICAL
EFFECTS OF THE PNEUMATIC HAMMER ON THE WORKERS IN
INDIANA LIMESTONE.
BY DAVID L. EDSALL, M . D.

In accordance with your request I went to Bedford, Ind., to con­
sult with Dr. Leake in regard to the effect of the pneumatic hammer
on the stonecutters. Leaving Boston at 2 p. m. January 5 , 1 arrived
at Bedford about 12.30 midday, January 7. Dr. Leake had so ably
and thoroughly gone over the situation before my arrival that I was
thereby enabled to accomplish a great deal in a few days. What I
have to say is based in very considerable part upon points that he had
elicited and at once demonstrated to me. The remainder of January
7, 8, and 9, including the evenings, in company with Dr. Leake, I
spent in going over the situation with Mr. Griggs, president of the
Journeymen Stone Cutters’ Association, with other officers of the asso­
ciation, and with several of the employers’ representatives, in inspect­
ing the mills and observing the men at work, and in examining and
talking with the men. On January 10 we went to Bloomington, both
in order to see more of the men and because the feeling of the mem­
bers of the stonecutters’ association there appeared, from what we
could learn, to have been more actively aroused than in Bedford, and
we wished to get the most positive evidence we could.
We repeatedly requested Mr. Griggs, the local officers o f the stone­
cutters’ association, and numbers of the men in both Bedford and
Bloomington to bring to us the men who complained most, or we
got their addresses and went to their homes. None of the men whom
we examined were sent to us through the employers and none were
examined in the presence of the employers or their representatives.
In Bedford we reached them chiefly in their homes, which had the
advantage of making them and their households feel quite free to
talk in regard to their condition. In Bloomington, Mr. Walters, the
secretary of the local branch of the stonecutters’ association, brought
the men to us. In both places the men seemed extremely frank and
open in what they said. They are as a class superior men in personal­
ity, education, and manner of living. It rapidly became apparent
that because the symptoms that I shall describe occur frequently,
and fear had been aroused in various ways that they might grow
114




SUPPOSED P H Y S IC A L EFFECTS OF TH E P N E U M A T IC H A M M E R .

115

worse, the anxiety of the men was due more to this fear of further
and more serious results than to anything known to have occurred.
In fact, several of those with the most pronounced manifestations
said to me that if that was all that it would do they thought it of
comparatively slight consequence. Their feajrs of bad results had
apparently been largely aroused within two years by their interpre­
tation of the opinions of some physicians who had seen some affected
men but, who, so far as we could learn, had not actually studied the
cases or the men’s work carefully but had rather, somewhat natu­
rally, based their advice upon the men’s own apprehensions.
The symptoms seemed, from the statements of these men as well
as from statements of men who use the air hammer in other trades,
to be almost exclusively, if not entirely, confined to stoneworkers,
and among the stoneworkers they occur almost entirely in those who
work with soft stone such as the Indiana limestone. The reason for
this becomes apparently clear when one observes accurately the man­
ner in which these latter workmen use the air hammer and especially
the manner in which they use the stonecutting or stone-carving tools,
and when one compares this with the details of the work of others
who use the air hammer. A t the same time, this offers a clear reason
for the location of the symptoms and to a considerable extent at
least for their character, and it furthermore suggests some very ap­
parent expedients that may be expected to reduce the discomfort and
that, if properly developed through experimentation, would probably
almost entirely or entirely do away with the effects which now, while
apparently never serious, are easily demonstrated, uncomfortable,
and justify a demand for a definite effort to overcome them.
The matter will be most evident if I first describe the symptoms
and then the character of the work. As to the symptoms: Dr. Leake
and I examined very carefully 19 men, and in going through the
mills and upon other occasions we examined casually and talked
with as many more. Dr. Leake, before and after my visit, saw many
others. Nearly all of these men stated that they had then or had
previously had, in very slight degree up to a decided degree, the con­
dition that we were there to study. This consists of temporary
blanching and numbness of the fingers when the hands are chilled.
It occurs almost entirely when the weather is cold, or at least quite
cool, and when they are exposed to the cold—not when they are in
well-heated buildings. One or two, however, believed that they some­
times felt it in summer, and several said that it annoyed them when
“ in swimming” in summer. It occurs chiefly when they start work
in the morning before they get “ warmed up ” and lasts from a few
minutes up to one and a half or two hours. A few men said it
tended to recur during the day when at work. It also tends to occur
when they walk or drive in cold weather, and when the hands are




116

REPORTS OF P H Y SIC IA N S OF PU B LIC H E A L T H SERVICE.

plunged into cold water or snow it can be brought out in a few
moments. Indeed, any exposure to cold causes it to recur. In ap­
pearance and in sensation they say it is precisely like overchilling
the fingers in winter so that they “ go dead,” the first stage of frost­
bite of the fingers. As in the condition just mentioned, there may
be some tingling or actual pain when it comes on and there is usually
tingling when the blanching passes off, at which time it is suc­
ceeded by a flush and congestion for a little time, and at this time
there may be a good deal of discomfort or actual pain, which, as
most people have experienced with chilled fingers, may extend up
the arms. Occasionally this is described as severe, but usually they
say “ annoying ” is a sufficiently descriptive term. The numbness
usually does not interfere with the use of their hands appreciably.
Occasionally they state that it makes them clumsy, slower, and less
accurate in their work while it lasts. Its distribution is striking and
important in relation to its causation. In the great majority of the
cases it is noticed first in the ends of the ring and little fingers of the
left hand; later it is felt predominantly, in many cases solely, in the
fingers of the left hand. In most instances, when definitely devel­
oped, it is felt chiefly and is often even later confined to an area on
the ulnar side, extending back to include the two distal phalanges
of the little finger or the whole finger, and running diagonally across
to the index finger where it involves only the last phalanx or a little
more. It gradually increases in some cases until it involves the whole
of all the fingers o f the left hand, occasionally going back along the
ulnar side to the wrist or over the whole hand to the wrist. The right
hand is very much less frequently affected than the left and then
usually less markedly. Ordinarily, when it occurs at all in the right
hand, it is chiefly noticed in the thumb and index or middle finger.
In a very few cases it appears to involve the whole of both hands.
The only instance of that extent that I actually saw was, however,
in a man from whom questioning brought out the fact that it had not
appeared, as is usual, toward the tips of the fingers and slowly in­
creased in area, but had come suddenly over the whole area when he
had 4 frozen ” his hands during a long drive in cold weather and had
4
subsequently, upon exposure to. cold, been always of that same extent,
slowly diminishing in intensity. In this case, therefore, while work
with the air hammer brought out the symptoms after they had once
appeared, it did not seem to have excited them in the beginning.
The distribution of the symptoms seems to be explained by the
manner in which these men hold the tool in the left hand and the*
hammer in the right; and, in the right hand, a factor o f importance
seems to be the practice of some of the men of controlling the ex­
haust from the hammer by pressing the thumb, index, or sometimes




SUPPOSED P H Y SIC A L EFFECTS OF TH E PN E U M A TIC H A M M E R .

117

the middle finger over the exhaust hole, a practice which the more
skillful men say is unnecessary and undesirable.
Sometimes after prolonged work the men have flexor contraction
of the fingers of the left hand for a few moments as they cease work—evidently because of the prolonged, constrained grip on the tool.
This is significant chiefly in suggesting the origin of their trouble.
Beyond what I have described the men sometimes complain o f
lameness in the arms, shoulders, or chest. Two said they slept badly
and twitched and turned in their sleep' after working hard with the
hammer. These two, however, looked to be in poor general condition.
Various other symptoms of vague character and significance were
learned of from some of the men. I may, however, for brevity’s sake
state here that neither questioning the men nor careful physical ex­
amination showed evidence that the symptoms mentioned, or any
others outside those in the hands, were of any particular significance.
They were rather such symptoms as some members of any group o f
men will always show when doing work, of whatever kind, that is
at times hard work and often carried out in constrained positions. In
making this last statement, I exclude any consideration of the effects
of dust upon the lungs. I was not asked to study that and did not do
so. I would say, however, that I was not impressed with any note­
worthy need of studying the dust hazard, which in working with
this particular stone seems surprisingly mild.
Some excitement had been caused by the fact that one stonecutter
had died insane. This case the men themselves now dismiss, however,
as having been due to general paresis. One man we saw had had an
ordinary acute facial paralysis. Quite naturally, in the apprehension
that had been aroused, such occurrences and various vague rumors
and suggestions had led to fears of “ paralysis,” Raynaud’s disease,
and a variety of other grave results. We could find absolutely noth­
ing to justify such fears, even in the stories we were told. It is en­
tirely conceivable that a neurotic subject might grow decidedly neu­
rasthenic from dwelling on the disagreeable sensation that these small
pneumatic hammers produce. Some of the men said that the sensa­
tion was exceedingly disagreeable to them at first, but all except the
nervously oversensitive soon get so accustomed to it that they pay
no attention to it. It is, in this way, like many other accompani­
ments of industry, as for instance, the noise in many forms of work.
The symptoms in the hands seem to constitute all the recognizable
effects of cutting and carving stone with the air hammer, and in
describing the results of physical examination and in considering the
cause and nature of the condition and the possible remedies, I should
be understood as referring solely to these hand symptoms.
When the men were at work in the mills in the early part of the
day, many of them showed in mild form and extent the blanching




118

REPORTS OP P H Y S IC IA N S OF PU BLIC H E A L T H SERVICE.

described above. The finger nails and the affected fingers were some­
times cyanosed instead of blanched. When seen in houses or in our
rooms just after they had come in from the cold the same condi­
tions existed. The weather was severely cold during my stay there.
After a short period in the warmth the affected area became flushed
and then after a further period looked and, they said, felt normal.
As I have said, except for occasional other symptoms that seemed to
have no distinctive relation to the work, nothing else was observed
and the men almost all stated that this was the whole trouble. One
man showed fibrillation of the muscles of the left hand, but it was
so slight as to be scarcely observable and such as is occasionally seen
without definite cause and since no one else showed it, it was prob­
ably o f no significance. None showed tremor except one who ad­
mitted the rather generous use of alcohol, and in him it was of the
usual alcoholic character. When cold and blanched the finger move­
ments were somewhat clumsy. When warm the motor power was
normal. There was no muscle atrophy observable. The hand grip
was normal, as were the wrist and elbow reflexes in all instances.
Sensation to touch, to pain, and to heat and cold was tested. When
blanching was present the sensation to pain and to heat and cold was
of course often moderately blunted over the affected area but became
normal in the warmth. In two instances there was apparently very
slight persistent reduction of sensation in the last phalanges o f the
third and fourth fingers of the left hand. Three men showed much
reduced pain sense in entirely irregular and changing areas over the
hands and forearms, but one of these was mildly alcoholized at the
time and the other two were of distinctly neurotic character, and
since the sensory disturbance was quite as marked over the forehead,
face, and neck, on both sides, it appeared, of course, to be unrelated
to the vasomotor disturbance in the hands and of no significance in
relation to the actual effects of the air hammer, except that a study
o f the hands and arms alone might easily have led to the decision
that there were organic nerve changes.
It is to be noted also that most of these men, owing to the grit
from the stone and the use of the tool and hammer, develop a very
remarkable degree of callus on the palmar surface and naturally
this is found particularly in the areas especially likely to be involved
by the phenomenon under study. The thickening of the skin fre­
quently extends up the sides of the fingers so as to leave soft skin
on only the back surface of the fingers, approximately three-fourths
of the finger surface being often somewhat calloused and also much
of the palm and the outer ulnar surface. Naturally, over calloused
skin the sensation, especially to pain, is somewhat lessened, but this
was of course equally the case in those men who had symptoms and
those who had none. It is important only in showing that one




SUPPOSED P H Y S IC A L EFFECTS OF TH E PN E U M A TIC H A M M E R .

119

might easily think mistakenly that there were persistent changes in
sensation even when the hands were warm and normal-looking.
In the 19 examined the stereognostie sense was normal. It was
examined especially because Mr. Griggs stated that the men some­
times could not distinguish coins by their feeling. In the 19 men
I examined carefully the heart and blood pressure were normal in
all but one, who showed a moderately high pressure. He told me,
however, that he had had syphilis. In all the 19 the blood vessels
felt normal, and in all pulsation of normal characters could be felt
in both'radial and ulnar arteries.
Aside from the callus there was no observable persistent change in
the skin. It was interesting that there were, even in the men who
had had symptoms for years, none of the redness and desquamation
even that one sees after mild frostbite, and they had no persistent
itching or burning.
The condition seems then to be purely a local vasomotor irritabil­
ity and there seems J o be no evidences of any nervous or other or­
b
ganic changes except possibly, in one or two cases, extremely slight
and vety localized sensory peripheral nerve changes. These were,
however, doubtful and seemed insignificant at most and may occa­
sionally be noticed in any workingmen who bring to bear as much
and as prolonged local pressure as these men do. In view of the fact
that the men who get symptoms usually do so within six months to
two years of the time that they begin the use of the air hammer and
that a large proportion of these men we examined, as well as very
many others, have used the air hammer for many years and never­
theless no worse results could be discovered, it is wholly reasonable
to conclude that this comprises the sum of the results and no organic
changes or more disturbing functional changes are likely to occur.1
We were unable to see or to learn of any cases in which the con­
dition described actually interfered with the men’s occupation as
stone workers, though we were told of two or three cases in which
they gave up this work either because of the discomfort it caused in
cold weather or because of apprehension that it might grow worse.
There does seem some possibility of its being a distinct disadvantage
if the man wishes to go into certain other forms of work that cause
exposure to cold. One man told me he had originally been a car
builder and after using the air hammer in stone work he tried to go
back to his old trade because he had had difficulties with the fore­
1 It is of some interest to note that one, and I think also a second, man said when seen
a few days before by Dr. Leake, that he had tried to bring out the phenomenon by
plunging his hands into snow, but was surprised to find it would not appear, though
usually marked. He said that he remembered afterward that he “ had had a couple of
drinks of whisky just before." This is of interest and of some importance in that it
indicates both the mild character of the disturbance and its apparently purely vasomotor
origin, since it was entirely overcome by the mild vasodilator action of the moderate
amount of alcohol.




120

REPORTS OF P H Y SIC IA N S OF PU B LIC H E A L T H SERVICE.

man in the stone mill, but had to give it up because he could not hold
a cold chisel firmly with his numb fingers in cold weather.
We were told of several young stonecutters who had been drafted
into the National Army and who were having a very uncomfortable
time in the cold weather, especially in carrying a rifle. Gloves do
not suffice to prevent the effect of quite cold weather.
However, skilled stonecutters, naturally, usually stick to their
trade and, as stated, I found none whose stone work was either
prevented or seriously interfered with. One man of those seen had
given up working on limestone and was using the hammer with com­
fort in working on granite. Both tool and hammer are used differ­
ently on granite. Five men stated that they had earlier had the trouble
decidedly but that it had gradually lessened until it had almost
entirely disappeared. They attribute this to having learned to use
the tool with greater skill and especially with an easier and less
cramped grip. Other experienced workmen told me the older and
more skillful men are bothered less than the younger and less
skilled, and attributed this to the same cause and to the fact that the
young men use the mallet little in “ roughing out,” while the older
men have more familiarity with the mallet arid use it a good deal.
Mr. Griggs stated also that it is more common in the young men
than in the older. He believed this due to the more common use re­
cently o f the larger hammer, but the older men state that they use
the larger hammers as much as do the younger men.
In considering the cause, the precise character o f the work must
be appreciated. It is easy to see, when one tries himself some of
the various uses of the pneumatic hammer, how peculiar results may
occur with soft-stone workers. In the first place they use hammers
of very rapid action. We were unable to get a reliable and definite
statement as to the number of blows delivered by these and other
air hammers. Dr. Leake is endeavoring to determine that accurately.
It is said to be with the smaller of these hammers approximately
3,000 to 3,500 a minute, with the larger, 2,000 to 3,000. Whatever the
exact figure the blows are so frequent that they can not be appre­
ciated individually by the ear but make a continuous note. Whereas
the hammers used in riveting, and most other metal work, act much
more slowly and the individual blows can be heard. The vibrations
are therefore much finer and more frequent in the hammers used by
the stonecutters. The difference one appreciates at once when hold­
ing the hammers at work.
Probably much more important in explaining the special occur­
rence of these symptoms in the soft-stone workers is the manner in
which they hold the hammer and more especially the fact that they
work with a tool held by the left hand in a peculiar manner. The
riveter simply grasps his (larger) hammer with both hands in a




SUPPOSED P H Y SIC A L EFFECTS OF TH E P N E U M A TIC H A M M E R .

121

manner convenient to reach the rivet with it. There is no loose tool
to be held. The granite worker holds the hammer perpendicularly
grasped in his right hand and while he does use a tool in the left
hand it does not need to be gripped firmly or guided forcibly except
in doing lettering or other fine work. These workers in limestone,
however, hold the hammer in the right hand as one uses a pen,
whatever force is exerted upon it being exercised by the thumb, fore,
and middle fingers; and the tool, like the hammer, is held obliquely,
in the left hand, is gripped firmly, held closely against the stone,
and guided, by a pressure exerted especially by the last two fingers
and running along a line which is practically that which I described
as delimiting the extent toward the hand of the vasomotor phe­
nomenon as usually seen in the left hand. The use of the left hand in
calking and chipping seems superficially to be much the same but
when one tries it, it is at once apparent that in these operations the
tool needs relatively little guiding or pressure and for this reason
and because the tool is larger (the shank of the stonecutting tool is
only half an inch or often less) the grip of the left hand is very
much less forceful and constrained than with the soft-stone workers.
It will, I think, be apparent that the symptoms in the latter corre­
spond in area closely to those areas of the fingers that are forcefully
used and extend from there peripherally. It is to be remembered
that these men use their hands continually, for most of their work­
ing days, in this manner unless they get frequent change by using
the mallet. But* as stated, most of them nowadays use the mallet
little. It is interesting, that some of the men state that they had the
same symptoms when working in earlier yjears with the mallet, but
apparently this was unusual and the symptoms then ordinarily were
slight.
There are three chief factors that evidently may play a part in pro­
ducing the symptoms— cold, constriction, and vibration. Cold is
evidently the chief factor that temporarily excites the symptoms, as
few of the men have any trouble except in the cold. But in the
many other trades in which the hands are equally exposed to cold
this phenomenon is unusual. In fact the stonecutters were in earlier
years, when they used the mallet, more exposed to cold than now.
I am inclined to believe that cold elicits the symptoms rather than
produces them, but it nevertheless gives the man discomfort. The
factors more peculiar to this trade are the constriction of the grip
exercised and the vibration. The vibration occurs almost equally, if
not equally, in other work, as in hard-stone cutting, with, relatively
little or no such effect; also, if the vibration were the chief, cause the
affection would be expected to occur more diffusely over the hands,
since the whole hand feels the vibration, and in more irregular dis­
tribution, and particularly it would be expected to spread radially




122

REPORTS OF P H Y S IC IA N S OF PU B LIC H E A L T H SERVICE.

from the source of vibration instead of being, as it is, observed
peripherally only for a long time, in most cases, and usually first in
the finger tips. It seems probable that the most important factor
and hence the one to be especially obviated is the continuous con­
striction. Much the same phenomenon may be temporarily and
easily brought out in most persons in cold weather by a similarly
strained continued grip. It can not, however, be either denied or
affirmed with the evidence at hand that the vibration is a factor of
importance.
It is obvious that certain simple things may be done to attempt
to eliminate the trouble. First of all the shank o f the tool, where it
is held, could be made larger so that the grip need not be so strained.
And in doing this it would be well to use some substance that would
conduct cold, or heat, poorly, instead of the cold metal used as at
present, that intensifies the effect of cold. Asbestos suggests itself
and its practicability could be tried. Some of the men have tried
rubber hose drawn over the tool but said it tended to work upward
on the tool and choke the action of the hammer. One man, however,
said that he soaked the hose in oil, drew it on his tools, and allowed
the softened rubber to adhere to the tool in drying and thereby was
able to use it successfully. He said that he had earlier had “ dead
fingers ” but is no longer troubled by them. Asbestos, if practical,
would have evident advantages. Some such handle would perhaps
serve also to some extent as a shock absorber and thus reduce the
possible effects of the vibration. It is possible too that practicable
methods o f keeping the tools warm in cold weather could be easily
devised and would reduce the discomfort. It is also to be noted
that the practice of controlling the exhaust with the thumb or fingers
o f the right hand should be discontinued. In the same connection
it is to be observed that in some hammers, due either to their con­
struction or to wear, the exhaust leaks downward along the tool
(which it should not do), giving a slight constant blast of cold air
on the left hand. This should be obviated. Heating the compressed
air has, I believe, been tried but meets with difficulties and I do not
believe it would be of much value even if successfully done.
Reducing the time spent at any disadvantageous work and shift­
ing to other forms of work is in many kinds of industrial disorders
sufficient largely to overcome the trouble. In this instance there
is an obvious way o f accomplishing this—by requiring the men to
use the mallet in suitable parts of the work, especially in “ roughing
out.” The operators say they have always preferred that this
should be. done, especially because compressed air is expensive, but
that the men will not do it. The men admit they use the hammer in
such work when they do not need to, partly because they get more
done, and because, they say, unless they do the foremen look unfa­




SUPPOSED P H Y SIC A L EFFECTS OF TH E PN E U M A T IC H A M M E R .

123

vorably upon them and are likely to drop them because they do not
work so fast. Evidently adjustments and understandings are needed
on both sides here. The men and the operators and their foremen
should recognize that the frequent shift to the mallet may go far to
obviate the trouble. While the tool is held in much the same way
when employing the mallet, there is a slight, almost automatic, re­
laxation of the grip on both the tool and the mallet handle after
each blow and this alternating relaxation and contraction is just
the desirable offset to the constant constriction exercised when using
the air hammer.
Mr. Griggs stated that he believed the 1-inch hammer should be
done away with in this work and only the three-fourths-inch ham­
mer used. The men differ Very much on this point. Many think the
smaller hammer gives them more discomfort. Certainly the im­
mediate sensation one gets in using it is more disagreeable than with
the larger hammer owing to the more frequent and finer vibrations.
From the evidence at hand, I do not believe that it is possible to
say whether limiting them to the smaller hammer would help di­
rectly. But it would perhaps lead the men to use the air hammer
less in “ roughing out,” and if that were the case it would probably
indirectly do good.
Besides these obvious measures there is little doubt that, having in
mind the above-mentioned factors that are probably active in pro­
ducing the trouble, an ingenious person of mechanical training and
familiar with the practical needs in the work could by some study
and experiment devise changes in the tools or the hammer or other
changes that would improve upon the above suggestions; and if the
latter were not of the character needed, he could devise means that
would be successful. While the disorder is not, under present condi­
tions, such as to justify any fear of more serious results, it is uncom­
fortable and possibly of some economic disadvantage to the men
and it is due to them that such studies as the above be made by the
manufacturers of the hammer or more especially by the soft-stone
operators, since of those who use the pneumatic hammer, it is their
interests that are particularly involved.







PART III. -ST A TE M E N T S OF PHYSICIANS REPORTING ON BEHALF OF THE
EMPLOYEES AND THE EMPLOYERS.
Testimony of four physicians is here presented.
The report of the first physician, Dr. C. E. Cottingham, of Indian­
apolis, covers seven cases whom he examined particularly, at the
request of the Journeymen Stone Cutters’ Association, to determine
the effect, if any, of work with the pneumatic hammer. His state­
ment is more emphatic than that of any of the other three doctors.
This is perhaps to be explained by the fact that the examinations
were made at a time when the use of the air hammer was the subject
of sharp controversy between the union and the employers, and the
statements made to the doctor by these men—statements which he
has accepted unquestioningly—may have been colored too highly
because of the state o f war that existed. He declares that if other
stonecutters are affected anywhere near so severely as those he
examined, the work is “ permanently and irreparably affecting the
nerves of their hands and, in some instances, their general health.”
He gives the symptoms as swelling, vasomotor change, and loss of
sensibility in the hands, pain, loss of sleep, and general nervousness.
In his opinion none of the cases he saw can become normal. He
even goes so far as to say that he believes everyone using the hammer
must suffer ill effects to some extent, and it is his belief that the use
of the hammer should be controlled by law.
Dr. Cottingham’s statement is as follows:
EFFECTS OF USE OE AIR HAMMER ON HANDS OF INDIANA OOLITIC-STONE
CUTTERS.
BY C. E. COTTINGHAM , M . D., INDIANAPOLIS, IND.

I have recently had an opportunity to examine and inquire minutely into the
effects and causation o f a disease that is affecting the stonecutters who use
the air, or percussion, hammer in their daily work. I have carefully and in
several instances made repeated examinations o f the effect o f this disease in
seven cases. I am informed that there are several hundred cases o f this dis­
ease in the State o f Indiana.
This being true, the matter has assumed grave proportions and has become a
sociological question o f which the State should take immediate cognizance. I f
the others are affected in any proportion as severely as those examined, they
are doing or being required to do work that is permanently and irreparably
affecting the nerves o f their hands and in some instances their general health.
125




126

ST A TE M E N T OP P H Y S IC IA N REPORTING FOR EM PLOYEES.

The disease is an occupational neurosis o f which no reports have been made to
the medical world, and I can find no literature whatever upon the subject. I
have necessarily had to depend entirely upon my own observations and the evi­
dence as given me by the patients examined.
I have no reason to doubt a single statement made to me by any one of
the patients. My own observations showed me objectively enough to warrant
the statement that all that these men state o f the pain they suffer is true.
Appended you will find a detailed report o f each case. It is necessarily
condensed and shows no evidence o f the amount o f work necessary to obtain
the information. I have excluded everything except the facts that are signifi­
cant in relation to the disease in question. I have used the patients’ expres­
sions in describing their symptoms to a large extent and do not present this
report as a strictly scientific one.
First, I w ill state that these men were all strong men physically. They had
the appearance o f men accustomed to hard work and men who were stoics and
not afraid o f fatigue or pain. They would not complain unless there was occa­
sion for complaint, and I do not believe they exaggerated in any particular.
Briefly stated, the symptoms o f the disease are as fo llo w s :
Swelling in hands.— The first symptom o f which they complained was the
fact that their hands swelled soon after beginning to use the hammer. Some­
times they swelled for five or six weeks. In one case the hands would swell
every time he began using the hammer after a lay-off. One reported a lump
the size o f a hen’s egg that appeared on the back o f the hand and remained for
two or three years.
Vasomotor change.— They all complained that their hands became white on
exposure to cold. This was a vasomotor change that is natural enough, although
people do not permit their hands to become cold enough to become white. In
these men it is probable that the hands became white at a higher temperature
than in most people. It is also probable that their hands are so benumbed and
rendered insensible to temperature changes that the men are not conscious
that their hands are cold until the latter become white.
Loss o f sensibility.— They all complained that their hands were numb. This
numbness was variously described. Some said that it seemed that their hands,
especially their left hands, were d e a d ; that they were not a part o f th em ; that
they could not tell they were there except when they looked at them. Especially
was this true on cold days. One said he could put his hand into boiling water
until the skin came off and not know it ; another that his hand felt as though
il was in cold water all the time. They all said that they frequently felt as
though their hands were asleep, as if they had pins and needles sticking in
them. Some said they felt this effect whenever they held their hands in one
position for 15 minutes. This numbness is a real thing and was proved to e^ist
by my examination.
They had lost the pain sense to a considerable extent, because I would stick
them with a sharp needle and they could not tell whether it was sharp or d u ll;
even when I pressed until the needle penetrated the skin they were not con­
scious o f it.
They had lost tactile sensation in their hands to a considerable extent. They
could not tell when touched w ith cotton as when a fly craw ls 011 their skin.
They could not tell when they were touched or the location, even when slight
pressure was used.
They had lost the temperature sense in the hands. They could not tell hot
from cold when I would use test tubes, one filled with almost boiling water,
the other with ice water.




EFFECTS OF U SE OF AIR. H A M M E R ON T H E HANDS.

127

I w ill state that these observations were confined to the hands. These men
were normal in their nervous systems throughout the rest of their bodies. The
lack o f pain sense in their hands was more especially shown in their tolerance
o f electricity. W ith one electrode in one hand and the other in the other they
could all tolerate 90 volts, using the combined galvanic and faradic currents,
and apparently show no evidence o f pain. When the electrodes were passed up
to their wrists they would immediately show evidence o f a normal condition
and be unable to tolerate such a current for an in stan t; when I would measur?
the amount o f current passed, I would find quite a difference in conductivity
between their hands and their wrists. Thus when the current was passing;
through from the electrode in one hand to the electrode in the other hand with
80 to 90 volts there would only be from 8 to 12 milliamperes measured on the
meter. I f one electrode was passed up to the wrist there would immediately be
registered from 20 to 25 milliamperes as passing. This difference is not present
in the normal man. It may be interesting to note that I am unable to tolerate
more than 50 volts from the same wall plate administered in the same manner
without suffering acute pain. Yet these men tolerated 90 volts without appar­
ently feeling it, and I was unwilling to test their endurance further, and so
did not find out their limit.
Pain endured.— They all complained more or less o f pain. Some said they
did not have pain while working but suffered for several hours after working.
One or two would suffer nearly all night. The pains were generally confined
to hands and arms, especially the left hand and arm. One or two could not
raise their arms, without pain, to the level o f their shoulders. Some had pain
in their necks. Others described various pains in their sides, backs, and calves
of legs. Some had the pain while working. I think all said they suffered pain
while working when they had to hold the machine in a certain position for a
long time, as when they were cleaning a flat surface or when “ straight tooling.”
They all said they had pain when their hands were cold. One said he did
not have pain except when his hands were cold, and then only while he was
“ warming up.” Incidentally he remarked that he had fainted two weeks ago
because of the pain while he was warming up. A big, strong man who denies
he has pain except when he is “ warming up ” does not faint from pain unless
that pain is severe.
Loss of sleep.— Five o f the cases said they could not sleep after working
with the air hammer. Two had quit work on account o f the doctors’ orders.
Some said they could not sleep more than two or three hours. Some lost weight
from 20 to 50 pounds wiiile using the hammer.
D ifference in blood pressure.— I took the blood pressure o f all examined. In
only two was it higher than normal. One I had a chance to observe for several
weeks. I took his blood pressure weekly for three weeks while he was working
and found his systolic pressure ranged from 150 to 157; diastolic, 100. The last
time he had not used the hammer for several days and his blood pressure was
140, systolic; 100, diastolic. This was in a man o f 50 years o f age.
General nervous condition.— These men were not the kind o f men you would
describe as “ nervous.” In three o f the cases the general nervous system did
not seem to be affected, but in the other four there was a profound effect as
shown by loss o f sleep, loss o f weight, worry, fear o f loss o f mind or health,
and increased blood pressure— such effects as w ill come to anyone who suffers
a continuous, nagging pain for a long time. They reported that one case had
become insane and died in a short time, and that this man had been warned
by his doctor that he must quit his work or he would go insane. Tw o o f the
cases had the fear that the same fate would befall them.




128

ST ATEM EN T OF P H Y S IC IA N REPORTING FOR EM PLOYEES.

In no case, in my estimation, would there be any improvement while w ork­
ing. H ow much improvement could occur if they stopped w ork with the ham­
mer is problematical. The cases examined, in my estimate, can never become
normal again, although they may improve enough so that they w ill not suffer
pain and may be fairly com fortable; but I do. not believe their hands can ever
regain their sensibility. These men state that when they work a short time
each day with the hammer and the rest o f the time with the chisel, in the old
way, they can get along fairly comfortably.
In other words variety o f occupation w ill not produce the sad effects evidenced
in their cases. H ow much o f the air-hammer work they can stand without ill
effects will unquestionably vary in each case and could only be determined by
experimentation.
But these men are irreparably damaged, and anyone who observes this ham­
mer in its rapid, violent vibration must realize that no man can hold it firmly
in his hands frequently in a strained position for eight hours a day five and
one-half days in the week, week after week, and year after year, without its
producing evil effects.
The effects may be confined to the hands in some cases and be evidenced
only by pain, numbness, and local effects. In other cases it will affect their
nervous system generally and they w ill become neurotic, neurasthenic, and, in
some cases, insane.
I do not believe anyone can use it, working with it continuously, without ill
effects in some way, and in a certain not small percentage it must necessarily
produce the most profound effect. I believe the use o f it should be limited
and controlled by the law.
Case No. 1.
[Employee No. 23 (see p. 24).]

Age, 39; w hite; A m erican; married.
Family h istory : N egative; has one child living and healthy.
Previous h istory : Has always been well until last few years. Has been a
»i,onecutter for 21 y e a rs; used the air hammer 8 years.
Patient’s statement: Is well except in hands, arms, and neck. Left leg is
affected and seems numb. Left arm and hand seem dead— “ go to sleep ” when
left 15 minutes in one position. Is much worse in cold weather. Three fingers
on right hand are affected the same w a y ; all on the left hand seem dead. Can
put hand in boiling water until skin comes off without feeling it. Pains when
cold. Pains in neck at tim es; attack lasts about two weeks, when he can not
move his head without intense pain. Pain is in the region o f seventh cervical
vertebra.
Physical exam ination: Strong, well-nourished, well-muscled individual o f
average height, and weight physically normal.
Neurological exam ination: Normal, except diminished tactile, temperature,
and pain sense in h an d s; worse in left hand.
Claims he has pain in middle third o f left upper arm. Can not raise arm
squarely above level o f shoulders.
Blood pressure: Systolic, 140; diastolic, 80.
Electrical conduction: Using 75 volts, there was a difference o f conductivity
between fingers and hand on wrist. Fingers and hands, 8 to 10 m illiam peres;
wrist, 16 milliamperes.
February 22. Blood pressure: Right arm, systolic, 157; diastolic, 100; left
arm, systolic, 140; diastolic, 100. Electrical conductivity (90 volts used,




EFFECTS OF USE OF AIR H A M M E R ON T H E H AN D S.

129

electrodes in both hands) : Six to 10 milliamperes on fingerg and hands; 20
milliamperes on wrist. Both hands the same.
February 23. Blood pressure: Both arms, systolic, 160; diastolic, 105.
Electrical conductivity: Both hands, 8 to 10 milliamperes (80 volts used) ;
wrist, 16 milliamperes.
This man, in order to show the effect o f cold, held his hand in ice water
until it would seem that it would freeze, and yet apparently did not feel
the cold as an ordinary man would feel it.
Case N o . 2 .
Age, 23; w h ite; A m erican ; married 9 months.
Fam ily h istory: Negative.
Previous h istory: Negative, never sick.
Patient’s statement: He worked at trade 9 years, 6 years with the hammer,
but never more than one year at a time. W ould stop because o f doctor’s
orders.
When he first began using the hammer a large bump on the back o f the
hand appeared as large as an egg, which lasted for two or three years; no
evidence o f this at this time. The fingers and outer half o f hand are numb
and dead on left hand; the thumb and first finger on right hand have same
feeling.
Has pain in the elbows and shoulders all the time while he works. This
pain continues, working and resting, while he is using the hammer. Has a
pain and numbness in neck and pain in base o f left hip. Arm hurts so badly
he can not raise it. H as not worked for two months. Arm still hurts and
hand is still numb. Awakes with hands and arms numb and “ asleep ” every
night.
Has peculiar spots appear on body, which go away when he works at other
work. Has three times been told to quit work to save his life. Loses weight
(20 pounds) when he works. Always has a pain below ribs when raising
hammer. Calf o f legs and knees hurt when he works. Is so tired he can
hardly drag home at night. Has worked five months in past y e a r ; farm s
between times. Still has the numbness, but not so much pain.
Physical exam ination: Reveals nothing w ron g ; slight, well-muscled physique,
about 140 pounds in weight.
Neurological exam ination: Negative, except the deep tendon reflexes on left
side diminished, and the numbness in hands. Has diminished pain, tactile, and
temperature sense in hands, especially the left hand.
Electrical condu ctivity: 90 volts were used and apparently not felt on h an ds;
very painful on w ris ts; 6 to 10 milliamperes were measured as passing through
the hands, 20 to 25 milliamperes when the electrode was on the wrist. This
condition was confirmed on fou r successive days’ observation.
Case No. S.
[Employee No. 1 (see p. 19).]

Age, 37; w h ite ; G erm an; married.
Fam ily h isto ry : N egative; no children.
Previous history: N egative; never sick.
Patient’ s statement: Has worked six years with the air hammer. W orks
seven months each year, eight hours a day, five and one-half days' a week. Has
pain in left arm, running up the arm to shoulder; has a feeling o f pins and
18476°— Bull. 236— 18------ 9




130

ST A T E M E N T OP P H Y S IC IA N K EPO K IIN G FOB, EM PLOYEES.

needles in hands and arms* Fingers get white when cold. Pain is worse at
n igh t; hurts for three‘ to five hours after w ork stops. Hands are numb and like
dead hands in morning. Has numbness or changed sensation down left side,
“ pins and needles ” in left foot. Very nervous and restless each evening. Has
a precordial pain and thinks this is from pushing the tool.
Claims Ms hands swelled for four or five weeks after he began w orking and
swell for a week or two when he first works after a lay-off. Pain is so severe
he gets sick. When he lays off for five months his hands do not hurt all the
time, but are always numb. Pain is not felt when he works, but begins when
he quits in the evening. Hands feel as if he has velvet on them when he touches
anything. Hands feel as if they do not belong to him, but are a thing separate
from his body. Pain begins when he quits work, continues till he goes to sleep,
then in morning hands feel numb. Has to put hands and arms in all positions
to sleep; can only keep them in one position for about 15 minutes, when they
pain him so much he must change the position, until at last he sleeps from
exhaustion.
The only time he has pain when he is working is when he is cleaning a sur­
face and holds his arms in a strained position fo r a long time. Then his arms
pain and ache. A t times when he is cleaning a hard surface he feels a sensa­
tion in his head as though his scalp were loose. He has to grit his teeth to keep
at work.
Physical exam ination: Strong, well-nourished, hard-muscled man, apparently
physically perfect.
Neurological exam ination: Negative, except diminished pain, temperature, and
tactile sense in left hand.
Electrical conductivity: Much reduced in hands, much less in the le ft hand
(90 volts used). On the left hand and fingers, 8 to 10 milliamperes were meas­
ured as passing; on the wrist, 20 m illiam peres; on right hand, 11 to 12 milliam­
peres passed on the hand and fingers, 25 milliamperes on the wrist.
This case was carefully examined for fou r successive days and the observa­
tions confirmed by repeated examinations.
This is a case presenting both severe local effects and severe effects upon the
general nervous system. The man had constantly before him the fear that he
would go insane. W ith the amount o f pain he constantly suffered and the loss
o f sleep caused by the pain and the added worry, there is danger that such a
fate may befall him.
Case No.
Age, 43; w h ite; E n glish ; married.
Fam ily h istory : N egative; has one child in good health.
Previous history: Is partially deaf from an in ju ry ; otherwise always well.
Has worked 25 years at his trade and 2 years w ith the air hammer.
Patient’s statem ent: H is le ft arm, hands, and fingers feei as i f they w ere in
cold w a te r ; feel numb and dead. His hand seems as though it does not belong
to h im ; he doesn’t know it is there except when he looks at i t ; pains when cold,
as if frostbitten. H is sleep is not disturbed. H is hand swells and pains when
he is cleaning and using tool on flat su rfa ce; pains when he is “ straight tool­
ing.” Feels worse at n ig h t; when hands are cold he can’t pick up anything with­
out looking at i t ; hands have no “ feeling."
Physical exam ination: N egative; a strong, well-nourished, haid-m uscled
man.
Neurological exam ination: Negative, except diminished tactile, temperature,
and pain sense in left hand.




EFFECTS OF U SE OF AIR H A M M E R ON T H E H A N D S.

131

Electrical conductivity: W ith 80 volts no sense o f pain was experienced in
the hands, but they were exceedingly painful on the wrists and elsewhere over
body.
This case was examined but once.
Case No. 5.
-A ge, 51; w hite; Am erican; married.
Fam ily h istory : Had one brother who had epilepsy and one sfsfcer who died
o f paralysis at 53; has fou r children, ail healthy.
Previous h istory: Negative,
Patient’s statem ent: Has worked at trade 32 years. When he began w orking
w ith the air hammer his hand and fingers got so he could not pick up a pencil.
H e was so awkward he could scarcely use them. A fter six weeks he could not
w ork regularly. Has worked about one year altogether w ith many intervals.
The tool makes the hand swell at first. Hand is numb and asleep. Has not
worked with hammer since September, 1916. This examination was February
20, 1917; hand is still numb. Has quit work by advice o f his physician. Says
lie was a nervous wreck. Lost weight, from 180 to 155 pounds. He could not
sleep at night and felt as if his eyes were “ pushed out.” W ould walk all night
at this tim e ; could not work more than half a day at a time.
Physical exam ination: N egative; a well-nourished, hard-muscled man.
Neurological exam ination: Negative, except in left arm and hand. Here
there was diminished tactile, pain, and temperature sense.
Electrical condu ctivity: The sense o f pain to strong electric currents was
much diminished, but my notes do not show that I measured the electrical con­
ductivity in this ease.
In this case the local conditions were not so apparent as in the other cases,
but the general nervous condition was much worse. Possibly because o f a dis­
tinct heredity he was made so nervous from loss o f sleep and general nervous
irritability that had he continued to work with the hammer it is probable he
w ould either have become insane or a victim o f complete nervous prostration.
Case No. 6.
Age, 47; w h ite; A m erican ; married.
Fam ily h istory : N egative; has six children, all well and healthy.
Previous h istory: No serious illness except typhoid fever four years ago.
W orked at trade 33 y e a rs; with hammer 16 years. Seven years’ steady w ork
in that time. Has not been working for past three weeks.
Patient’s statem ent: H is left hand is numb, especially on cold or damp days.
Hand gets white when cold. He has fto trouble except in left hand and arm. These
hurt when cold, especially when “ warming up.” Although he said in a matterof-fa ct way that his hands pained him when warming up, he also said that he
fainted one week ago when his hands were “ warming up.” This fact shows
the degree o f pain he suffered, as a man does not faint from pain unless the
pain is considerable.
He states his hands always pain him when working on a cold day, but do not
pain him at other times. His work does not affect his sleeping.
Physical exam ination: N egative; a strong, well-muscled man.
Neurological exam ination: Normal, except in hand. There was numbness
and diminished pain, temperature, and tactile sense.




132

ST A TE M E N T OF P H Y S IC IA N REPORTING FOB EM PLOYEES.

Electrical condu ctivity: There was no response to electricity and no evidence
o f sensation until 85 volts were used. The comparative conductivity was not
measured in this case, as I had only one opportunity to make an examination.
H ere wT a man o f iron nerves and stoic disposition. I f he could not work
as
with the air hammer it would be useless for anyone to try.
Case No. 7.
Age, 50; w hite; Am erican; married.
Fam ily h istory: N egative; has four children, all healthy.
Previous h istory : Negative. Has worked at trade 33 years and w ith the air
hammer 3£ years.
Patient’s statem ent: H is arms and hands are numb and pain him— severe
pains at times. H as lost 30 pounds since he began using the hammer. The
pains began after five or eight months o f use and affect the arms, hands, and
stomach. H as frequent cramping and has burning urination. Can not sleep
when he works. Has averaged three or four hours at night for the past six
weeks. Is exceedingly nervous, restless, and irritable. H as had to quit w ork
and go home on account o f indigestion, vomiting, etc. The last attack o f this
character wT three months ago, but has had frequent attacks.
as
Physical exam ination: Normal, except the blood pressure— systolic, 157;
diastolic, 100.
Neurological exam ination: Negative, except diminished pain, tactile, and
temperature sense on left hand.
Electrical condu ctivity: No sense o f pain on hands when 80 volts were used,
but marked pains when the electrodes were passed up to the wrists. On the
left hand, 12 to 16 milliamperes were measured, while the same voltage gave
25 on the w ris t; on the right hand the difference was 18 to 20, as against 25
milliamperes on the wrist.
He was examined successively once a week for several weeks. There was
no difference in the examination except in the blood pressure, which was as
fo llo w s :
February 21: Systolic, 157; diastolic, 100.
February 24: Systolic, 150; diastolic, 100.
March 3 : Systolic, 150; diastolic, 100.
March 10: Systolic, 140; diastolic, 100.
During the first three weeks he was using the hammer and was not sleeping
more than tw o or three hours at night and his blood pressure was too high.
On the last examination he was not using the hammer and was sleeping
about six hours and his blood pressure was normal. This man w ill become
an old man before his years if he continues to use the hammer.

The second physician, Dr. Francis M. Barnes, jr., of St. Louis,
was requested to come to Bedford and examine, on behalf of the
employers, some supposedly typical stonecutters. Seven men were
selected by the employers and requested to go to the headquarters of
the employers’ association and permit this physician to examine
them. Three men were brought to him by a surgeon o f the United
States Public Health Service, who selected them as interesting cases.
Dr. Barnes made no attempt to discover cases o f the ailment com­
plained of in Bedford; his examination was confined to those who
were brought to him, the majority of them by their own employers.




EFFECTS OF H A M M E R ON PH Y SIC A L AN D M E N T A L H E A L T H .

133

The fact that these men were so selected and that they were examined
in the employers’ headquarters by a physician brought in by the
employers throws some doubt on the testimony given by them, testi­
mony which the physician accepts without question.
INVESTIGATION INTO THE EFFECTS OF THE PNEUMATIC HAMMER ON
THE PHYSICAL AND MENTAL HEALTH OF OPERATORS.
BY FRANCIS M . BARNES, JR., M . D., ST. LOUIS, MO.

Introduction .
The investigation upon which the follow ing report is made was conducted
in.Bedford, Ind., December 27 to 80, inclusive, 1917. In its scope the investiga­
tion included an inspection o f n?ills and a survey o f the working environment,
interviews with workmen using the pneumatic tool, and with the superinten­
dents o f mills, and detailed physical, neurological, and mental examinations o f
10 subjects who had used the air hammer for a number o f years.
The superintendents o f two large mills were interviewed. Both o f these men
had been in the stonecutting business for more than 20 years, beginning at the
trade before the pneumatic hammer was introduced. Both had used the chisel
and mallet in the early days, and one had had considerable experience, not
only in personally working at his trade with the pneumatic hammer, but
through having been in charge o f the installation o f pneumatic equipments in
several large stone mills. In meeting with these men one is impressed that
they are o f that good, solid, more intelligent, honest grade o f laborers who
have reached their present positions o f supervision with authority and trust
because o f their integrity and demonstrated ability to fill the place to which
they have been promoted from the ranks. These men testify that they per­
sonally have been troubled with “ w’hite fingers ” and “ dead fingers ” such
as have been described in connection with the use o f the pneumatic hammer,
but that they had this trouble when using the chisel and mallet. According to
their statement, the three fingers o f the left hand, beginning with the little
finger, were most affected. Neither o f these men suffered any permanent dam­
age, although one has also used the air hammer extensively, and at the present
time their hands reveal nothing unusual in appearance and show no impair­
ment in use. It is their opinion that the “ white fingers ” and “ dead fingers ”
observed in stonecutters are more or less incident to the trade; that the hand
which holds the chisel (the left) is usually and most severely affected;
that this is largely, if not wholly, due to the cold and the cramping position o f
the fingers from the tight grip o f the chisel and is not blamable directly either
to the mallet or to, the air hammer, excepting in part, especially where the
latter is improperly used, i. e., in such a way that the exhaust is impeded and
forced to discharge from the drill socket along the drill and thus bring a
draft o f cold, damp air onto the fingers with the consequent effect o f the cold.
Selection o f subjects and manner o f examination.
In the selection o f subjects for examination it was deemed advisable for com­
parative purposes to have representative groups, as an examination o f every
worker in this industry o f this district was not feasible. Therefore, they were
picked according to factors which were considered o f importance, such as their
age, their length o f service at the trade o f stonecutter, the duration o f the use




134

ST ATEM EN TS OF P H Y SIC IA N S B E P O E ilN G FOB EM PLOYEES.

o f the chisel and mallet as well as the air hammer, and according to the
effects, or absence o f them, which might be attributed directly to the use o f
the hammer under reference. In most instances the subjects were selected by
the employer who was instructed only in general terms as to the type o f man
wanted. These men did not know until sent to the place o f examination that
they were to be so investigated, and came directly from their work w ithout
making preparation, excepting two or three. Three were selected through
the aid o f a surgeon from the Federal Bureau o f Public Health, who had been
detailed to investigate the air hammer in the stone industry. These three
were commonly reputed to be among the *most active o f those workers who
complained o f the damage which they claimed resulted from the use o f the
air hammer under reference. To each subject it was explained that whatever
inform ation he might give was voluntary, that it would not be used ( if at
all) in connection with his name or in any way to act to his detriment.
It is obvious that such a selected representative group, very carefully and
thoroughly examined from all viewpoints, would be likely to give more val­
uable inform ation and trustworthy data from which accurate conclusions
could be drawn than could a much larger group more incompletely and casu­
ally examined. From one and a h alf to two and a h alf hours w ere consumed
with each subject in this study. These 10 workers represented fou r cut-stone
companies o f the district* excepting two who were not at the time employed.
The inform ation concerning the individual subject was given in each case by
him just before the physical examination itself was made.
Follow ing the interview the subject was shown to another room, asked to re­
move all clothing and get into bed. All tests were made w ith the subject in
the recumbent position in bed, excepting where, from the very nature o f the
test, other postures were necessary, such for instance, as testing gait and
station. Weights recorded do not include subject’s clothing unless noted other­
wise. Each case w as examined in an orderly, systematic manner, carefully
and repeatedly when necessary or otherwise advisable, and without haste or
interruption. W ith the hot and cold sensory tests only moderately cold and
moderately warm test tubes were used— neither hot or icy cold— neither ex­
treme. Visual acuity w as determined by the ability to count fingers at nine
fe e t; visual field ascertained for the four quadrants but not charted; pupils
and eyeballs were examined by the aid o f an electric flash light and under a
len s; opthalmoscopic examination made with the W appler electric instrum ent;
hearing tested by conversational tones and tuning fo r k ; sensation w as investi­
gated by the use o f a needle, cotton, and tuning fo r k ; blood pressure was de­
termined with the Faught aneroid instrument and a stethoscope. The findings
were recorded during or immediately at the conclusion o f each examination.
The examiner alone was present during the interview and while the subject was
being questioned as to history and, also, during the examination, excepting
in one instance when the above-mentioned surgeon from the Federal Bureau o f
Public Health w as present during the physical examination.
Resum e o f results o f examinations.
These subjects were examined directly upon coming from their w o rk ; that
is, within one-half to tw o hours, excepting two who w ere not employed at the
time o f the investigation.
Fam ily history.— Four had history o f tuberculosis, two alcohol, and tw o
nervous disorder. No history o f cancer, other constitutional, or mental disease.
Personal history.— The subjects examined were all males o f the Caucasian
race, in ages from 24 to 54 years. Their general past as w ell as present




EFFECTS OF H A M M E R OUT P H Y SIC A L A N D M E N T A L H E A L T H .

135

health was good in every instance. All w ere robust, strong, well developed,
and well nourished. In fou r there was a history o f some “ rheumatic ” ten­
dency. No history o f nervous or mental disease, epilepsy, unconsciousness, or
the like. Seven carried life insurance, in two this was not noted, one was
not insured. None had ever been refused insurance or had their rate increased.
One admitted gonorrheal infection and one both gonorrhea and syphilis;
otherwise venereal disease was denied. Eight o f the 10 used tobacco fo r smok­
ing or chewing or both. In 6 there was a history o f alcoholism. All subjects
were married, 7 had living and healthy children, and only 1 gave a history o f
the w ife having miscarried or aborted. All reported a good appetite. One
admitted constipation. One complained somewhat o f sleep being disturbed.
A ll 10 reported no recent loss In weight.
Occupational history.— The years during which these 10 subjects had worked
at stonecutting ranged from 9 to 41, with an average o f 22.5 years, only 3
having given up the trade for any length o f time since first beginning; 1
for 1£ years while in the Army, 1 for 4 years while holding a civil position,
and 1 fo r 12 years while working on a farm. These 10 subjects had used the
air hammer at their trade from 3 to 22 years, averaging 9.3 years. All o f them
had worked with the chisel and mallet before using the air hammer. All had
worked in limestone principally, though three had also worked with the air
hammer ’in “ hard ” stone.
Concerning the troubles with their hands, nine reported “ white fingers ”
while using the air hammer and fou r o f eight questioned reported similar
troubles while working with the chisel and mallet. Of the nine mentioned all
had the trouble in their left hand, three in addition having had similar trouble
in their right hand. Not one reported swollen fingers. Three subjects re­
ported that the fingers also were painful or subject to paresthesias o f nonpain­
fu l character. In only one subject was the condition o f “ white fingers ”
actually present and examined during this investigation. In four subjects
there were reported disturbances in the arm and shoulder, two o f the right
side and two o f the left. These disturbances were of the nature o f stiffness
or soreness with occasionally some pain, and were o f the general character
commonly known as “ rheumatic.” Five o f the subjects expressed an opinion
that the air hammer caused the trouble mentioned in the hands, though one o f
this five would rather continue with the hammer than give it up. In all, seven
expressed themselves in favor o f the continued use o f the air hammer, only
three complaining o f the damage which they thought it did them. Only one
subject thought the ham m er'itself was solely to blame for the condition in the
hands; one thought the hammer was the principal cause; two thought it was
due to the action o f the hammer combined with the low temperature and the
grip on the chisel; six believed the trouble entirely due to the cold and the
grip on the chisel, attributing to the air hammer no part in its causation.
Exam ination.— In no subject were there any evidences o f neurotic tempera­
ment or mental disorder. Injuries bearing on the health in general or the
nervous system were not present. No disease o f the organs o f the chest and
abdomen was found. No glandular enlargements. Pulse was normal, a slight
degree o f arteriosclerosis being prfesent in two or three subjects, but" no more
than to be expected at their age. The blood pressure was within normal
limits, if anything somewhat lower than the average normal, but in no sub­
ject increased.
Cranial nerves: In tw o subjects irregularity o f outline o f one pupil was
n oted; in one there was slight impairment o f hearing on one sid e; otherwise
the cranial nerves were all negative.




136

STA TEM EN TS OF PH Y SIC IA N S REPORTING FOR EM PLOYERS.

Sensation: In nine subjects, aside from the hands, sensation was normal.
In one there was reported some dulling below the elbows and below the
knees on both sides, but this was not constant or definite.
Motor system : Four subjects showed a fine rapid tremor o f the hands.
One complained o f tenderness over the calf muscles and in the right shoulder.
Otherwise the motor system was normal.
Reflexes: The reflexes in eight subjects were all normal. In one the ab­
dominals were absent. In one, reduced reflexes, suggesting locomotor ataxia,
were observed.
H a n d s: In only one subject was the condition o f “ white fingers ” observed.
In all others the hands were somewhat reddened and flushed, but no more than
might reasonably be expected to be found in outdoor laborers. The hands were
calloused to a varying degree in different subjects, but in all quite extensively.
The palm and certain o f the fingers o f the left hand were more calloused than
the right. There was no actual cyanosis, excepting in one subject where this
was slight. No swelling, no tenderness, no pain, no edema, and no involvement
o f the muscles or joints. Paresthesia was absent, excepting in one subject,
who reported some numbness in his “ white fingers.” Sensation for all tests
was acute and practically normal. There was in most subjects a lowering o f
the acuteness o f feeling, some blunting or dulling, but this certainly was no
greater than could be expected in hands where there was so much callus pres­
ent. In all but one subject the callus w as sufficient explanation for any varia­
tion from the normal which could be observed in sensation. This subject, dur­
ing' the brief period o f time that the “ white fingers ” were present, did present
some sensory impairment, but it is considered that this was due entirely to
the low temperature, coldness o f the hands depending upon vasomotor, and
not especially nervous, disequilibrium.
Interpretation o f findings.
The condition observed in the hands o f some stonecutters is not one corre­
sponding to any disease known to medicine. The fact that such a condition, as
is here under reference, has not been described in medical literature is, in
itself, most highly significant. Whereas the stonecutter has been working at
his trade for centuries and the pneumatic hammer has been used in this
trade for more than two decades, this condition o f the stonecutter’s hands has
only been brought to attention within the past two years. I f a specific disease
o f the stonecutter’s hands existed it is inconceivable that it should have so
long escaped the attention, not only o f the medical profession, but o f those
interested in labor questions generally. That it is not due to the pneumatic
hammer directly and primarily is proven by the fact that the condition was
known to exist prior to the introduction o f this tool. That the air hammer
may have added somewhat to the frequency o f its occurrence, as compared
with the period when the chisel and mallet were used exclusively, is possible,
but not proven. An extensive comparative study, which circumstances nat­
urally made impossible, could alone settle this question. Again, the fact that
the trouble, when present, preeminently affects the left hand, w hich holds the
chisel and not the hammer, indicates clearly that other factors than the ham­
mer itself are o f more signal importance in its causation. The cramped posi­
tion o f the chisel hand w ith the more or less continuously maintained con­
traction o f the muscles is one o f these important factors. However, the ham­
mer or the grip on the chteel, either alone or combined, are not sufficient to
produce the condition as is proven by the fact that it does not occur in the
warmer seasons o f the year when the stonecutting industry is at its height.




EFFECTS OF H A M M E R ON PH Y SIC A L AND M E N T A L H E A L T H .

137

Therefore we have left the factor o f low temperature, which seems to be the
final and most important factor in tlie production o f those vascular changes
seen in the hands o f some stonecutters, which, although physiological in na­
ture, form the pathological basis for the occurrence o f stonecutters’ “ white
fingers ” and “ dead fingers.”
So far as can be ascertained the condition leads to no permanent disability
and results in no organic disease. W hy it is that only a portion o f stonecut­
ters are affected can not be answered. Whether certain undetermined conditions
o f poor general health or specific diseased conditions existing, but not recog­
nized, predisposes certain stonecutters to this disturbance is not evident from
this investigation, although apparently such is not the case. It is a generally
accepted fact that stonecutters, as a class, show a high mortality rate for
tuberculosis. This is true for sandstone workers (76.5 per cent o f deaths), but
not so for workers in limestone (7.5 per cent o f deaths). On the contrary,
working in limestone has been recommended as advantageous to those w ith
the tubercular predisposition. The use o f alcohol among stonecutters is rather
generally acknowledged to be prevalent, but its bearing upon the condition here
investigated does not loom large. Although the small number o f w orkers
examined in this investigation does not permit o f extended conclusions, it at
least appears apparent that the general health o f these men is, as a rule, good.
W ith one or two exceptions they were all well-developed, robust men without
demonstrable general physical or mental disease.
Conclusions.
Conclusions drawn from a comparatively small series o f observations must
naturally be subject to some limitations. However, the uniformity o f the
results o f the examinations made in this investigation, taken together with the
testimony o f the workmen and o f others, reasonably justifies the follow ing
deductions:
1. Stonecutters working in limestone, as a class, enjoy good general health
and are not, because o f their trade, especially susceptible to any particular
disease.
2. Stonecutters are liable to a disorder affecting the hands, particularly the
left hand.
3. This disorder o f the hands is o f a vascular character, not due to organic
changes in the circulatory system, but dependent upon vasomotor reactions.
4. These reactions are physiological in character and are occasioned by three
factors incident to the work o f stonecutting. These are: (a ) Mechanical irri­
tation o f the skin, (b ) continued muscular contraction o f a cramping nature,
( c ) low temperature, cold.
5. Of these three factors, cold is considered the most important because, (a )
the condition only occurs during very cold weather and never in the summer,
(b ) warmth and measures to restore the circulation (rubbing, swinging the
arms and the lik e) cause its disappearance.
6. It can not be caused by the air hammer alone because, (a ) it occurs in
tli3se who have not used the air hammer, (b ) it does not occur in warm weather
when the stonecutting industry is at its height and, therefore, when the air
hammer is most in use, (c ) it occurs mostly in the left hand and not the right
hand in which the hammer is held.
7. This vasomotor disorder is o f temporary duration and is not known to
have resulted in permanent disability of the hand nor itself to have been the
cause o f developm «it o f any other local or constitutional disease.




138

ST A TE M E N T S OF P H Y SIC IA N S REPORTING FOR EM PLOYEES.

8. It is probable that once having occurred, the person is rendered more sus­
ceptible to its reappearance ju st as is the one who has had his ears or fingers
frostbitten or “ nipped ” by the cold more susceptible in these parts to the sub­
sequent exposure to cold. This explains the occurrence o f “ white fingers ” in
stonecutters when not actually engaged at cutting but otherwise exposed to
low temperatures.
9. There is no sufficient reason in the signs and symptoms presented in this
disorder to conclude that one has to do w ith Raynaud’s disease, acroparesthesia,
neuritis, or an occupational neurosis.
10. The institution o f measures to warm the chisel before and while using,
the wearing o f gloves, and the discontinuance o f the prevalent custom o f block­
ing the exhaust outlet and thus forcing a draft o f chilled air out along the
chisel and onto the fingers o f the left hand would do much tow ard the preven­
tion o f this trouble.

The reports of the third and fourth physicians are concerned with
results of the use of the air hammer in the marble industry. Both
reports were made at the instance of employers in the industry,
EPPECT OP PNEUMATIC TOOLS ON MARBLE W ORKERS.
B Y TH O M A S H . H A C K , M . D., PBOCTOB, VT.

Herewith I submit report o f my examination relative to the use o f the air
tool in the marble industry. In the building shop o f the Vermont Marble Co.,
at Proctor, Vt., there are in all 46 marble cutters who use the air tool. About
fou r weeks ago [this statement was made Feb. 28, 191S] I personally exam ­
ined 45 o f them. One man was out o f town but he was known to be free from
any disability whatever. The ages o f the men vary from 26 to 56, the aver­
age being slightly over 41. They had used the air tool steadily from 3 to 23
years, the average number o f years being almost 14.
The examination was made topically, with the follow ing results:
1. The question was asked “ W hat local symptoms do you complain o f ? ”
Nine had no symptoms, 34 the usual symptoms, and 3 unusual symptoms.
The usual symptoms, as is generally known, consist o f a slight degree o f
numbness in cold weather in the three middle fingers o f the left hand. There
is no pain at any time and the numbness lasts only a short while. There is no
indication whatever o f any serious or permanent injury from this cause; in
fact, o f these 34 men, 5 stated that they had the same numbness when using
the old method o f mallet and hammer.
Unusual symptoms are mentioned in three cases. One complained o f pain in
the precordial region after using tool for some time each day. The pain was
relieved by pressure. There was no relation to the use o f the air hammer.
The second complained o f a numbness in left arm coming on about 4 or 5
o’clock every morning. This man was in the hospital some 18 months ago
suffering from a heart lesion. The third man complained o f pain in the left
hand and forearm after work. H e was left-handed. He has had several at­
tacks o f muscular rheumatism.
2. Is there any swelling o f the hand or fingers?
Forty-five showed none whatever.
3. Is there pain after stopping w ork?
“ No,” 41; “ Yes,” 4. O f these 4 cases 1 can be explained as rheumatism.
The second complains o f a numbness o f left arm coming on about midnight




EFFECT OF P N E U M A T IC TOOLS ON MARBLE W O RK ERS.

139

and lasting fo r a short time. The third complains o f numbness o f left hand
at times, but part o f his w ork consists o f “ roughing off ” for carvers, which
is done by the hammer and chisel and not with the air hammer. The fourth
complains that left forearm aches every night. Since my examination this
man has been in the w oods chopping and he now complains o f the same pain
and in both arms.
4. Pain in other parts o f the body?
“ No,” answered by 43. Tw o answered affirmatively. Both cases were found
to rise from other causes than the use o f hammer, one being a precordial pain
and the other being due to muscular rheumatism.
5. Nervous symptoms?
Answered “ No ” by 45.
6. D o you consider your nerves affected in any w ay by the use o f the air
hammer?
Answered “ N o ” by 45.
7. The sensations o f touch, pain, and temperature were tested and it was
found that they were normaL
Aside from this specific examination, I am in a position to testify as to the
general health o f these men who use the air tool. I have been practicing
medicine and surgery in Proctor for 18 years and have served most o f these
men in a professional way during all the time that they have lived here and
thus have had every opportunity to be posted on their general health and to
become aware o f any occupational diseases if any such should develop. I can
testify that in my judgment the use o f the air hammer in the marble industry
is not responsible for any general injurious effects on the health o f the workers.
A STUDY OF THE EFFECTS OF THE PNEUMATIC HAMMER UPON WORKERS
IN THE MARBLE INDUSTRY.
BY

ARTHUR

P.

H EREIN G,

M. D.,

BALTIMORE,

MD.

Marble cutters .
The facts set forth in this report are based upon a study o f the men working
In two o f the largest marble plants in Baltim ore and o f the men employed in
structural-iron work at one o f the large shipbuilding yards adjoining Baltimore
City. A total o f 50 men were examined or interviewed regarding the effects
o f the use o f the air hammer. The result of this investigation reveals the
presence among a small percentage o f the men o f a condition which they term
“ white fingers.” This w as found to be purely a local affection o f two or three
fingers o f the left hand and an effect o f low temperature, which causes a con­
traction o f the blood vessels o f the fingers holding the chisel. Consequently
there is present on a cold day a feeling o f numbness and usually a blanching
o f the skin o f the little, ring, and middle fingers o f the left hand which dis­
appears upon placing the hand in warm water or rubbing the fingers for a
few minutes. This condition is present only during a cold spell, is present
only in a minority o f the workers, is purely a local affection, and is recoverable
and preventable.
This work began during October, 1917, when frequent visits were made to
the Hilgartner marble plant and the Evans marble plant, both located in
South Baltimore. During the same month, the shipbuilding yard o f the Riter-




140

STA TEM EN TS OF P H Y SIC IA N S REPORTING FOR EM PLOYERS.

Conolly Co. at Fairfield, Anne Arundel County, was visited and a number o f
tlie men using the pneumatic hammer were examined. A final visit was made
to the marble plants during January, 1918, when the temperature was below
freezing.
At the first visit a general inspection o f the entire plant was made and the
sanitary and hygienic conditions observed, as well as the varying character of
the work done by the men. The plants were found to be well lighted and well
ventilated and to be especially free from dust. The plants are steam heated
and are kept at a com fortable temperature except, o f course, in zero weather,
such as was experienced recently. Every man using the air hammer was ob­
served and interviewed while at w ork and came later to the examiner in a
private room in the plant for a thorough physical and mental examination.
The men who complained o f cold or numb fingers were given an examination
which included a review o f their family, past and present history, a physical
examination o f the thoracic and abdominal viscera, testing the superficial and
deep reflexes. Sensory tests as to pain, touch, and temperature were carefully
made. The muscular system as to tremor, strength, and coordination o f the
muscles was recorded. Pupillary reactions, visual acuity, and any changes in
the eye grounds were noted. The men spoke freely concerning their condi­
tion and cooperated in every way.
The examinations in October were made while the weather was mild, and
at that time none o f the men w as being troubled with cold fingers. They would
simply relate the experiences they had had in the past. In January, 1918, an­
other interview was had with the same men when the temperature was below
freezing, and they were working with the air hammer in a heated mill. This
visit was made about 9 a. m., and none o f the men had at that time cold,
numb, or white fingers. Some had had the condition early that morning and
a few others were affected only after work in the evening, but without excep­
tion it was found not to affect any o f the men while working.
In one group o f marbleworkers examined [cases 1 to 13], whose ages range
from 22 to 53 years and who have worked at their trade from 7 to 35 years
and have used the air hammer daily for periods varying from 7 to 25 years,
no serious effects, other than having two or three fingers o f one hand (usually
the left) feel numb and cold for a short time during very cold weather, have
resulted. This condition is transitory, purely local, and leaves no aftereffects,
and is not associated with pain or weakness o f the part, nor does it in any way
interfere with the efficiency o f the individual. Furthermore, it occurs in less
than one-third o f the men employed in the trade using the air hammer, and it
certainly can not be considered to be a serious condition or one which in any
way is injurious to the mental or physical health o f the individual.
Another group o f men [cases 14 to 35] had used the air hammer fo r periods
ranging from 4 to 25 years without feeling any ill effects or complaining o f
their fingers being numb, cold, or white. Each o f these men was seen and
talked to in person.




141

EFFECTS OF P N E U M A T IC H A M M E R ON MARBLE W ORKERS.

AGE, LENGTH OF TIME AT TRADE, AND NUMBER OF YEARS’ USE OF AIR HAMMER OF
MARBLEWORKERS WHO DO AND DO NOT COMPLAIN OF COLD AND NUMB FINGERS
DURING COLD WEATHER WHEN USING THE AIR HAMMER.

Men who complain.
Num'
Num­ ber of
ber of years'
Case Age. years use of
No.
air
at
trade. ham­
mer.
1

53

35

2
3

47
43

33
28

5
6

4

7

47
58
52
41

25
40
35
25

8

34

22

9
10

36
32

15
15

11

22

7

12

50

30

13

31

12

Nature of complaint.

25 Three fingers of left hand and index finger of right numb
and cold.
25 Three fingers of left hand numb in cold weather.
24 Three fingers of left hand numb and white in cold
weather.
22 Two fingers of right hand numb and cold in cold weather.
16 Left hand numb.
15 Three fingers of left.hand numb in cold weather.
12 Two fingers of left hand numb and white in cold weather.
Treated by doctor.
12 Three fingers of left hand numb and white in cold
weather.
12 White fingers on left hand, Uses alcohol to excess.
10 Two fingers of right hand numb and cold in cold
weather.
7 Middle finger of right hand cold and white in cold
weather.
20 Four fingers of left hand cold and numb in very cold
weather.
11 Three fingers cold and numb.

Men who do not com­
plain.
Num­
Num­ ber of
Case Age. ber of years'
years use of
No.
at
air
trade. ham­
mer.
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35

65
65
59
53
47
49
52
51
45
54
43
47
39
41
36
43
30
29
29
25
24
19

40
40
40
35
35
32
30
30
30
28
27
25
25
20
20
20
16
15
8
7
6
6

25
19
20
25
25
22
25
16
15
20
14
20
22
14
12
10
8
7
8
7
6
4

Structural-iron w orkers .
The men who were examined were working on a large steel oil barge, and
were using the air hammer eight hours daily out in the open. These men
usually wear gloves while at work. O f the 15 calkers and Shippers, only three
were found who complained o f cold or numb fingers. The condition was transi­
tory and never interfered with their work.
The riveters, who frequently have to work in strained and uncomfortable
positions, had no trouble with cold fingers, but at times complained o f stiffness
o f the muscles o f the arm and shoulders from the unnatural positions they had
to assume while at work. These men are exposed to more hardships than
marble workers and use a much larger and heavier hammer, receiving more
vibration from the hammer, but no serious effects were found.
Conclusions.
1. The most striking fact is that, although the air hammer has been used
for the past 25 years in various industries, such as marble, limestone, granite,
and structural-iron w ork in all o f its various branches, not a single case has
been reported in medical literature regarding the ill-effects o f its use. Nor
is there any mention made o f the condition which the few men affected term
“ white fingers.”
2. It would not have been possible for a definite disease entity to have es­
caped the observation, or failed to have been recorded by medical authorities
for nearly a quarter o f a century, if such a disease had existed.




142

ST ATE M E N TS OF P H Y S IC IA N S REPORTING FOR EM PLOYERS.

3* The large group o f men examined were found to be in very good health,
indicating that there is nothing in their trade or surroundings which makes
them subject to disease or lessens their efficiency in any way.
4. The group o f 13 men out o f over 50 examined, who complained o f the
so-called • white fingers ” is a very small number, and further, not one o f them
*
has ever had to lose any time from his work on this account.
5. The condition which the men have termed “ white fingers ” is simply a
reaction o f the skin and underlying blood vessels to the stimulation o f the
cold, and is a physiological or natural result o f the effect o f low temperature
on the skin.
6. The men examined have been using the air hammer from 6 to 26 years,
most o f them working daily, 8 hours a day and 6 days in the week without
developing any disease which has caused them any serious inconvenience or
permanent disability.
7. The comparison o f the symptoms o f the condition termed “ white fingers ”
with other diseases which affect the skin and blood vessels o f the fingers show
very conclusively how dissimilar this condition is from those o f a known char­
acter with well-defined symptoms.
8. O f the 50 cases examined, only 13 o f the men had any complaint to make
regarding the use o f the air hammer. Practically all o f the 13 cases were
affected alike, that is, they stated that in very cold weather the three fingers
(second, third, and fou rth) on the left hand became cold, numb, and at times
white. There was no pain at any time. This condition is not present as a
rule during fo r k in g hours-, but comes on in the evening after work and is
present in the early morning, if the weather is cold. The numbness disap­
pears after a few moments when the fingers are rubbed or dipped in water.
It never interferes with their ability to work and is present only during cold
weather. Usually only the tips o f the three fingers are n um b; in a few cases
the fingers are cold as far back as the second joint. In no case was the entire
hand affected. There is no cramp o f the muscles, nor is there any tremor or
weakness o f the hand or arm.
9. The condition known as “ white fingers” is not a disease, has no path­
ological foundation, produces no disturbance o f function o f the part affected,
and is to be classed simply as a local reaction o f the blood vessels o f the
fingers to the cold.
The physiological “ white fin gers” are better understood when w e compare
them to several pathological conditions which appear somewhat similar, but
entirely dissim ilar when carefully analyzed. The differential diagnosis table
o f related conditions is appended.
Neuritis -is a pathological condition due to an inflammation o f the nerves,
caused by an injury, occupation, or some poison, such as alcohol, lead, etc. The
symptoms vary according to the causes which produce the inflammation. In
general, there is pain and tenderness along the course o f the nerve, paresthesia,
and loss o f sensation, with finally paralysis o f the part.
An occupational neurosis is a disturbance o f the muscular movements caused
by overuse and fatigue, which manifests itself in pain, tremor, weakness or
cramp o f the group o f muscles involved. There is loss o f function, but no
complete paralysis, as a rule. A partial list o f occupational neuroses is as
follow s: W riters’ cramp, telegraphers’ cramp, seamstress’ cramp, shoemakers’
cramp, money-counters’ cramp, musicians’ cramp, masons’ cramp, blacksmiths*
cramp, and watchmakers* cramp.




EFFECTS OF PN E U M A T IC H A M M E R ON M ARBLE W ORKERS.

143

COMPARATIVE DIAGNOSIS OF NEURITIS, OCCUPATIONAL NEUROSIS, CHILBLAIN,
AND “ WHITE FINGERS.”
[For definitions of neuritis and occupational neurosis see preceding text statement.J
Neuritis.

Occupational neurosis.

Chilblain.

“ White fingers."

Not symmetrical as a
rule.
More frequent among Caused by exposure to
neurotic persons.
dry cold or even to
cold, damp air, with
sudden increase of tem­
perature caused by go­
ing close to the fire.
Attacks the nerves of Develops gradually May affect any exposed
and affects the mus­
the feet and hands
part of the body, i. e.,
cles used in a partic­
nose, ears, fingers, or
and extends up the
limbs.
ular occupation.
toes.
Severe pain along course Some pain and stiff­ If severe, there is pain.
ness or cramp of
of nerve.
muscles. No pain
along course of nerve.
Signs of inflammation. No signs of inflamma­ Part gets red, swollen
tion.
and hot, and itches.
May break down into
ulcers.
Sensory changes.
No sensory changes.

Usually symmetrical.

Not symmetrical as a rale.

More frequent among
men, depending upon
occupation and use of
alcohol.

Occurs among men who use
steel chisel during cold
weather, on marble, gran­
ite, or structural-iron work.

Weakness of arms or No paralysis of part.
Recovery usually
legs; finally paralysis.
good.

Recovery usually good;
recurrence on expo­
sure to cold.

Affects only the fingers of the
left hand.
Not accompanied by pain,
redness, or swelling.
Not accompanied by pain,
redness, or swelling.
No sensory changes of a per­
manent character.
No
change in the nerves or
blood vessels of a perma­
nent character.
No muscular weakness, tre­
mor, or cramp of muscles.
Numbness and paleness of
fingers relieved by rubbing
or placing x
>art in warm
water. Recovery during
warm weather; recurrence
during cold weather.

A vasomotor trophic neurosis is a pathological condition in which there is a
disturbance o f the vasomotor nerves associated with trophic or nutritional
changes, accompanied by sensory changes, i. e., pain, paresthesia, and gan­
grene o f the part, with consequent loss o f function.
COMPARATIVE DIAGNOSIS OF VASOMOTOR TROPHIC NEUROSES AND “ WHITE
FINGERS.”
[For definition of vasomotor trophic neurosis see preceding text statement.]
Raynaud’s disease.
Symmetrical
grene.

gan­

Acroparesthesia.
Symmetrical
character.

in

Erythromelalgia.
Symmetrical
character.

In

Scleroderma.

Usually bilateral in In majority of cases
affects o n l y the
character.
fingers of one
h a n d (usually
thelelt).
An infrequent dis­
ease.

Not a common dis­ Not£requentexcept Not a frequent dis­
among, w asher­
ease.
ease.
women.
Occurs in neurotic Neurotic persons
persons.
specially liable.
Mo r e f r e q u e n t More f r e q u e n t Occurs in either Occurs especially
sex.
among w o m e n
in adult women.
a m o n g women
and children.
over 30 years of
age.
Attacks extremities, Tips of fingers usu­ Rarely affects the Affects face, chest,
hands.
usually fingers,
arms.
ally affected.
toes, etc.
Not caused by occu­ Not affected by
pation or changes
temperature.
in temperatuie.




‘‘ White fingers.”

Tips of fingers get
cold, pale, and
numb. Does not
extend up the
hand or arm.
. Is present only
during very cola
weather.

144

STA TE M E N T S OF P H Y SIC IA N S REPORTING FOR EM PLOYERS.

COMPARATIVE DIAGNOSIS OF VASOMOTOR TROPHIC NEUROSES AND “ WHITE
FINGERS.”—Concluded.
Raynaud’s disease.

Acroparesthesia.

Erythromelalgia.

Scleroderma.

Paroxysmal. Se­ Pains in fingers Begins with burn­ Pain, numbness,
vere pain precedes
ing pains and
very severe, with
and a feeling of
numbness and
the attack, parts
tenseness are pres­
reddening of the
are numb, pale,
pallor. Pallor of
skin on the distal
ent. Pain not
fingers and hands.
and
waxy. A
part of the feet.
severe. Skin be­
blue-red discolora­
Skin is red and
comes f e d and
No discoloration.
tion of skin on
No gangrene.
tense. Has a
swollen.
symmetrical parts,
glass-like appear­
often followed by
ance.
gangrene. Mental
symptoms of de­
pression and gas­
tric disorders often
occur.
Paresthesia
and Pain is “ as if liv­ Sensory changes
pain.
ing fire were un­
not marked.
der the skin.”
A recumbent posi­
tion and cola re­
lieve the pain,
while it is' made
worse by walking
and warmth. It
is worse in sum­
mer.
Movements of the Condition is usu­ E x t e n d s o ve r
many years with
ally chronic, but
affected parts are
remissions.
hampered.
life not endan­
gered.

“ White fingers.”
N o pain. No
swelling. No
redness of skin.
Skin is shrunken,
but not hard.

No
sensory
changes.
E x e r c i s e and
warmth relieve
condition.

No weakness or
paralysis.

APPENDIX A.— EFFECT OF AIR HAMMER ON HANDS OF GRANITE
CUTTERS.
In order to secure inform ation concerning the alleged occurrence o f the
affection, the follow ing letter was sent to Mr. James Duncan, international
president o f the Granite Cutters’ A ssociation :
J a n u a r y 15, 1918.
Mr. J a m e s D u n c a n ,
International President, Granite W orkers'
International Association o f A m erica.
D e a r S ir : This bureau is having a special investigation made into the effect
o f the use o f the pneumatic chisel on the health o f stonecutters in the Indiana
oolitic limestone belt. Dr. Alice Hamilton, who is making this investigation,
writes me that “ the employers insist that granite workers use the air hammer
as much as do limestone cutters and yet never have dead fingers, but the men
say neither statement is true. Granite cutters, according to them, do not use
the hammer nearly so continually and they also say that in Quincy, Mass.,
fou r granite cutters were recently rejected by the exemption board because o f
such a condition o f the hands.” Have you inform ation on this matter? I f so,
will you kindly send such inform ation to me at your very earliest convenience?
I would be greatly indebted to you for any data that you can secure fo r me in
regard to the effect o f the use o f pneumatic tools on the health o f granite
cutters.
W ith anticipated thanks for your courtesy,
I am, very truly yours,
R oyal M eeker,

Commissioner o f Labor Statistics.
To this communication Mr. Duncan replied as fo llow s:
Q u i n c y , M a s s ., January 28, 1918.
In reply to your letter o f January 15, will say that the employers
Alice Hamilton, who had been investigating the effect o f the* use
o f the pneumatic chisel on the health o f soft-stone cutters in the Indiana oolitic
D e a r S ir :
who told D r .




APPEN D IX A.

145

limestone belt, that granite cutters use the air hammer as much as limestone
cutters and yet never have dead fingers, stated to her what they knew to be not
only a misleading but a false statement.
The statement is true that granite cutters use the pneumatic chisel as much
as do limestone or soft-stone cutters, perhaps more so, for the harder the
material the more justification there would be for the use o f the pneumatic
or any improved tool. The pneumatic machine is used so much in the granite
cutting trade at the present time that workmen who have entered the trade in
recent years and who are known as finishers— that is to say, men who perform
the neatest and best part o f the work, in fact all o f it after a stone has been
squared up or polished— scarcely have the use o f the old hand tools, and only
middle-aged or elderly men in ou r.trade who in entering it had nothing else
but the hand tools are considered expert now in both the use o f hand tools and
in the use o f the pneumatic tool.
O f course, any one who has used the tool for a number o f years and who
is o f a somewhat nervous temperament and, therefore, is apt to hold the tool
quite tightly in his hand in a very short time falls a victim to numb fingers,
and quite a number o f our members have been refused enlistment by examin­
ing boards because o f having numb fingers principally o f the left hand which
they use to hold the tool. I f a great amount o f care is taken in acquiring the
use o f the tool and keeping it up afterwards by holding it somewhat loosely
in one’s hand, the strain and vibration do not then affect the nerves and hand
tissue so much, but the pneumatic tool is so useful and can do work so much
better and more quickly that men o f my trade could not be induced at the
present time to think o f giving up the use o f the tool. They and inventive men
in tool making, etc., are all the time perfecting the use o f the tool, which from
time to time to some extent reduces the evil effects. It has recently been
asserted, for instance, that if electricity instead o f compressed air were used
as it is used in some instances, the vibration would not be so great and the
injury not so severe.
I think the evil effects o f the use o f this tQol have been longer in evidence
in the granite-cutting industry than among soft-stone cutters, because, as I have
stated, I think the tool itself has been longer and more effectively in use owing
to being better adapted to delicate and intricate work than the hand tools in
producing artistic ornamentation, and in fact the convenience o f this tool in
granite ornamentation has been the cause, as was recently much mentioned in
the press in connection with the Mary Baker Eddy Memorial o f hard white
granite cut in New York City and now erected in Mount Auburn, Cambridge,
o f making the hardest o f granites yield to the neatest kind o f ornamentation
coequal to anything which can be done in cutting marble or limestone.
W riting upon the subject generally, and which is in line with the inquiry at
the end o f your letter, will say that we have no specific statistics upon the
subject, and in as far as data are concerned, I may say that while men o f my
trade have put up with the pneumatic tool because o f the beneficient trade
result above referred to, they have no love for it as fa r as the effect upon the
nerves and hands are concerned.
Following up what may have been beneficient in the use o f this tool, manu­
facturers and granite-cutting tool makers proceeded to put into the granitecutting sheds a tool known as a hand surfacer. This has reference to dressing
surfaces by a pneumatic machine being held by hand on small surfaces and
where the machine could, therefore, be easily moved from one place to another,
producing a plain surface similar to that produced by the ordinary surfacing
machine, which is a large, heavy machine used to dress plain surfaces. This
hand machine had a very bad effect on workmen’s hands, wrists, arms, and
nerves, so much so that some men who held the tool quite tightly in the hand
while it was running were known to jump right out o f bed at nighttime and
fall on the floor because o f the condition o f their nerves, and the one workman
jollied the other by saying that the man affected “ had the jumps.” Not only
was this tool deteriorating in that respect but it creates an enormous amount
o f fine dust, and as it could only be used where men were cutting granite in
the ordinary fashion in the granite-cutting sheds instead o f being put outdoors
or segregated from hand workmen, the effect was injurious to the health, not
only o f the man running the hand surfacer but o f all the men within quite a ,
number o f feet from where he was employed. A great deal o f power was
turned into the machine *to make it dress surfaces equally and which added

18476°—Bull. 236—18----- 10




146

APPENDIX A*

to the discom fort o f the men operating it. This high power made the tool
jum p and hump unless it was held down hard and fast on the surface o f the
stone, and which required great strain and power in the hands and shoulders
o f the man operating i t This process gave the hand surfacer the nickname
“ bumper ” and is, therefore, known throughout North America in our trade
as the “ bumper.”
The men o f our trade are not opposed to improved machinery, but In this
instance they took a stand against the use o f this machine because o f the
effect it had on men’s hands and arms, and because o f the great increase it
caused in the percentage o f men dying from tuberculosis. Therefore, w e have
had a section in all our collective agreements with employers fo r years which
provides that “ hand surfacers— so-called bumpers— are not to be used.” This
has practically driven the bumper out o f the trade, and the only instances o f
its use are nonunion granite-cutting jobs where the workmen have not collective
protection to take care o f their health and their lives.
A word o f explanation about the increase o f tuberculosis w ill no doubt be of
interest Granite dust per se is not unhealthy, for throughout the w orld where
granite is cut where those pneumatic tools and machines are not in use tuber­
culosis is as much unknown as could be found In any occupation. This hand
surfacer, in place o f giving off the waste in granite cutting in chips or small
spauls, as is done with ordinary hand tools, ground off the waste very fine.
Quartz or silica, being the leading component part o f granite was, therefore,
plentiful in the dust, and when ground fine is exceedingly sharp, and when
breathed either through the nostrils or through the mouth slightly adheres to
the walls o f the bronchial tubes instead o f passing on as does the softer dust.
This causes a slight irritation which, i f not promptly and properly attended
to, and unless the workman is in the very best physical condition, causes
inflammation in the throat, and which being added to daily in small particles
in time causes hoarseness, later on sore throat, still later a cough, and by and
by the throat, bronchial tubes, and lungs are so affected that the w orker dies
about 45 years o f age. W hile tjie so-called bumper was in use the percentage
o f deaths by tuberculosis in our trade rapidly rose, and since we have refused
to use the tool because o f its unhealthy condition tuberculosis is not increasing
but has slightly decreased as the cause o f the death o f our members. Thus,
you see, we have gone through a process connected with the use o f tools o f
that kind which is yet unknown in the soft-stone industry. This is because
many o f the air tools we use in cutting granite can not be used profitably or
at all in cutting soft stone. The sharp, crisp dust in the cutting o f granite
falls away from the tool as it is used, or, as we say, “ the tool clears it s e lf”
in cutting granite, whereas the dust in soft stone would adhere to the cutting
tools when plates or peens are bolted together, thus form ing a sort o f a claybound condition and which would prevent the tool from cutting.
Our trade association has also, through its trade agreements with employers,
arranged that the large surfacing machines already referred to shall be placed
apart from men using the hand tools or the ordinary pneumatic chisel so that
they w ill not come in contact with the dust from the surfacing machines, and
according to situation and location they require those machines to be placed
25 to 75 feet from the nearest place where granite cutters are employed with
the ordinary tools o f our trade. This relieves all the men excepting the one
running the machine and who has some protection in that by his manipulation
o f the machine he contrives to throw the dust away from him instead o f toward
h im ; in all instances where it possibly can be done he w ill stand and operate
the machine with his back to the wind because the wind will then blow the dust
away from him.
In many Instances we have been able to induce employers to attach what are
called suction devices to those surfacing machines to draw the dust from the
cutting tool and carry it away from where workmen are employed. This
process is more healthful, but o f course, more costly and it is difficult to get
very many manufacturers to attach the suction device to those machines be­
cause o f the cost. W e have been successful in getting their sympathy and
support especially where the employers had been granite cutters and knew the
bad effects o f dust, and by and by as inventions are produced a condition will
^ be found in our trade whereby our members w ill very likely refuse to run a
surfacing machine unless it Is supplied with a dust removing suction device
and we w ill give all kinds o f encouragement to that thought as soon as it is
evident there is a practical dust-removing suction device available. Experi-




APPEN D IX B.

147

ments are going on which are encouraging, but the devices so far nsed are few
in number and sometimes not entirely practical.
I could not do justice to the subject mentioned in your letter without going
into these details, and hope that I have measured up to what you required in
your important and very interesting inquiry.
Yours, respectfully,
Jam es D u n c a n ,

International President.

APPENDIX B.— MINUTES OF BEDFORD LOCAL OF JOURNEYMEN
STONE CUTTERS’ ASSOCIATION OF NORTH AMERICA.
M eeting 6f March
1916.— Moved and carried that this local notify head­
quarters that after May 1, 1916, this branch refuses to use the air hammer,
and have it put before the executive board for an early decision.
M eeting o f Septem ber 8, 1916.— Report o f conference committee on proposed
agreement accepted and committee given a vote o f thanks. Moved and carried
that the committee representing the Bedford branch to the Belt Conference
stand with the representatives o f the locals in the Oolitic Belt Conferences on
the proposed agreement [doing away with the air hammer].
M eeting o f January I t , 1917.— Accepted report o f Belt Conference committee —
rate 671 cents and question concerning the use o f the air hammer to be taken
up by the executive boards o f contractors and stonecutters.




ADDITIONAL COPIES
OF THIri PUBLICATION MAY BE PROCURED FROM
THE SUPERINTENDENT OF DOCUMENTS
GOVERNMENT PRINTING OFFICE
WASHINGTON, D. C.
AT

10 CENTS PER COPY
V


Federal Reserve Bank of St. Louis, One Federal Reserve Bank Plaza, St. Louis, MO 63102