Medical Impressions of the Miners' Strike

Sirs, - There is another aspect of the recent strike that deserves consideration, and that is the effects upon the miners‘ wives and children. There is no doubt that owing to the nature of the meals—in this district soup was the staple diet, with roughly 3 ounces of bread per capita per diem - a deficiency of vitamins was frequently present in their diet. The soup was as a rule boiled for three hours, a vitamin-destroying process, and, in many instances, unless furnished with a medical certificate, the children, who for the most part were fed at school, received little or no milk.

During the three months' strike I had occasion to attend two cases of scorbutus the direct result of inefficient feeding. The first case was that of a mentally deficient child, aged 6, whose father was a member of a soup kitchen committee. The child had received practically no milk, but was fed almost entirely on soup, and was given an additional supply of this concoction owing to the father’s official position. The child, who on the previous day was attending school, was covered with a discrete, purpuric eruption, the distribution being trunk and limbs. There was in addition ecchymosis of the arms and legs, and profuse haemorrhage from the gums and nasopharynx. Antiscorbutic remedies were ordered, consisting of metagen - which is said to contain all the vitamins, fat-soluble A, water-soluble B, and water-soluble C (antiscorbutic) – and orange juice, together with adrenaline for haemorrhage, but the child died of syncope within twenty-four hours and before metagen could be obtained.

A month later the second case occurred - a girl aged 5 - in whom the signs were exactly analogous, with, in addition, slight haemorrhage from the vulva and melaena. One could not place a sixpence between the purpuric spots on the greater part of trunk and limbs, the face and neck, as in the first case, being spared. The child’s dietary was as follows: Breakfast (at school), cocoa to which condensed milk was added, bread and margarine; dinner (at home), soup from soup kitchen containing over-cooked vegetables, with now and then a slice of bread added ; tea (also at home), bread, tea with condensed milk. An immediate improvement was observed following prompt administration of metagen and orange juice, with milk and liberal supply of fresh vegetables. The haemorrhage ceased and the purpuric eruption almost disappeared in six days, marked improvement being noticed within forty-eight hours.

The age of the children is worth noting, for they are then more vulnerable because of the lack of stored•up vitamins as compared with the adult. I have observed no evidence of deficiency disease amongst the women, but many lost weight—an advantage with the obese—although signs of semi starvation were evident in one case, phthisis in another. As regards the men, as they themselves acknowledge, they never felt better in their lives.— I am, etc.,
J. Boyd Primmer. Cowdenbeath. Fife. Scotland. July 10th
[BMJ, 13 Aug 1921, Vol. 2 (3163), pp. 260-261]