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Disease from Phosphorus



The introduction of the manufacture of phosphorous, or lucifer, matches, which commenced about forty-three years ago, created a new form of disease, caused by the inhalation of the phosphorous vapors given off from the phosphorus. This disease, an extremely painful one, affected the jawbone of the worker, causing necrosis or death of the bone. It was not detected until the year 1s45, when it became well defined in the public hospitals at Vienna. To Dr. Letheby we are indebted for the first light that was shed on the subject in this country. The mischiefs, when they oc curred, were all produced by the use of white phosphorus, the common phosphorus of commerce. In the match manufacture the fumes of the phosphorus were inhaled at every step in the process, from the stirring of the mixture, through the dipping, to the boxing of the matches. While the disease was extant I made a very careful investigation of it in respect to its develop meat and course, and reported the facts in one of my lectures on the " Medical History of Diseases of the Tt eth," delivered in 1s5s, and published in 1s60. The facts, briefly described from that lecture, are that the symptom first complained of was pain, deep seated in the teeth, and having, usually, one tooth for its centre. It was not a toothache, nor was it strictly confined to the particular tooth, but extended steadily and persistently along the lower jaw, and was much intensified when the jaw was gently percussed or struck. In time the disease became concentrated in the jaw; a slow inflammatory process occurred and a thickening of the bone, ending in death of the bony structure, with attempts, in parts, at regeneration. In short, what is called a true necrosis was devel oped. In the worst cases, where the patient was not relieved by operative measures, hectic supervened, with copious night-sweats, extreme pain, and even death from exhaustion. It was remark able that no bones except those of the jaw were affected, even in the worst cases, so that the disease was purely local, and, indeed, was disconnected from the other symptoms of phosphorous I inferred that the malady was due to a volatile acid of phosphorus, which was absorbed by the saliva, and affected the jawbone whenever the teeth became unsound and the alveolus, or edge of the jawbone, became exposed. This view accounted for many of the anomalies, namely, that the lower jawbone alone was affected, that the enamel of the teeth escaped injury, and that workers whose teeth generally were sound escaped the injury altogether.

When the phosphorus disease once commenced, it continued in progress over periods of one, two, or even three years. It was in some cases so localized in its extent that only the teeth came out; in others it extended through the whole of the bone. I com pared it, in 1s5s, to a chemical destruction of the bone, with in flammation from the irritation produced by the foreign products of decomposition. I see no reason to modify that definition.

In treating of the phosphorus disease, I have spoken of it in the past tense. I have done so because, fortunately, the affection is now all but extinct. The discovery made by Lundstrum, of Sweden, that red or amorphous phosphorus could be applied for the production of matches, led to a complete revolution in the match making business, and to the introduction of what is called the safety match. By this plan the red amorphous and practically innocuous phosphorus was placed on the box, and the combustible substance put on the match was made of materials that were per fectly harmless to health.

teeth, jawbone, affected, jaw, match and bone