Medicine: For Stiffened Lungs

Doctors never get rich by treating silicosis. A poor man’s disease, silicosis hits miners and other workers in dusty places. In remote mining valleys, in slums near dust-ridden factories, the victims drag out their lives, struggling for each breath. Silicosis is by no means rare. It causes more than 20% of the “natural deaths” among the anthracite miners of Pennsylvania. In eight hard-coal counties, there are 1,000 new cases a year. But little has been done thus far to check or cure the disease.

If miners are poor individually, collectively they are rich. Last week their rich union, the United Mine Workers of America, announced that a research project financed by its welfare fund had at last done something for victims of silicosis. The work was carried out by a team from Jefferson Medical College, Philadelphia, led by Dr. Burgess L. Gordon. The key discovery—how to get healing drugs into silicotic lungs—was made by Dr. Hurley L. Motley.

When a miner breathes finely divided silica (quartz), the sharp microscopic particles, lodge in the little sacs at the ends of the air tubes in his lungs. The irritation forms scar tissue, whose stiffness keeps the sacs from collapsing, as they normally do, to expel air from the lungs. Breathing becomes harder & harder until the miner has to use all his strength merely to keep his blood oxygenated. Bacterial infections, including tuberculosis, often add to his misery.

Various drugs (mostly those which constrict the blood vessels) might help even serious cases. But when the victim tries to breathe the drugs into his lungs as fine mist through a “nebulizer,” they do not penetrate deep enough. Struggle as he will, the stiffened sacs remain full of stale air and of carbon dioxide from the blood.

Dr. Motley combined the nebulizer with a “cycling valve”—a sort of artificial breathing apparatus developed for the Air Force. With it he forces air, or oxygen, into the lungs of silicotics. The air passes through the nebulizer, picking up the drug mist. When the lungs are full, the valve goes into reverse and empties the stiffened lungs more thoroughly than the victim’s breathing muscles can do it.

At Philadelphia and in a clinic in the heart of hard coal country, Dr. Motley tried this apparatus on 500 silicotic miners. All of them reported various degrees of relief. But a partial cure is not enough. Soon the United Mine Workers will send research teams down into the mines to find out if silicosis can also be prevented.