commission held that the disability was not due to accident, but was an occupational disease and not compensable. In Illinois injuries that might be classed as diseases were admitted under the act, one case being that of a punch pressman who after three days' work found his arm numb from constant vibration, with acute pain, necessitating cessation of work. The diagnosis was traumatic peripheral neuritis, resulting in practical loss of the use of the right arm. An award was made over the contention that there was no accidental injury within the meaning of the compensation act. So also in the case of an employee working on an inside pipe at a pumping station within from 1 to 5 feet of a gas flame. There was inperfect combustion, and death followed within 24 hours after a collapse, an autopsy and analysis of the blood showing cerebral hemorrhage caused by gas poisoning, caused by inhaling the unburned particles of the gas. The industrial board took as its definition of an accident, "an untoward event which is not expected or designed,” and ruled that there was a causal connection between the conditions of employment and the resulting injury warranting the award.

A New Jersey case quite similar to that of the dishwasher in Colorado is one that was passed upon by the New Jersey supreme court, where claim was made for an eczema probably due to acid used in a bleachery. This was held not to be an injury by accident, since no specific time or occasion of its occurrence could be pointed out. (Liondale Bleach, Dye & Paint Works v. Riker, 89 Atl. 929.) The industrial commission of Wisconsin in November, 1913, and December, 1914, had before it cases in which claims were made for disability from lead poisoning. In the earlier case it is said that "lead poisoning is an occupational disease and is not contemplated within the provisions of the act, except such as might follow so quickly and proximately from some specific condition in the employer's business that it could be included within the meaning of the word 'accident' as used in the law." In the other case it was said that if the poisoning was due to the inhaling of lead it must have been through a considerable period of time," which in its culminative effect resulted in an occupational disease, which is not an injury within the meaning of the act.”

The Pennsylvania law limits its benefits to injuries due to "violence to the physical structure of the body"; however, claims were presented in a case of anthrax without evidence of any wound or cut, and in one of palsied wrist caused by inhaling acid fumes, the industrial board holding in both cases that the act did not extend to such injuries.

Disfigurement.-Injuries disfiguring but not disabling raise questions under an act whose intent is economic and not to make good

suffering or injuries not interfering with industrial opportunity. The industrial board of Illinois made allowances in cases where, even though there was no wage loss immediately effected, it was probable that the disfigurement was sufficient to affect the earning capacity or opportunity for employment in another occupation; in a case where scars on the head would not be seen unless the hair was cut very short, it was ruled that no award was warranted. The Iowa statute was construed by the compensation commissioner of the State to give compensation only in cases of actual disability, and no claim was allowed in the instant case. It was said, however, that no decision was made on the question of a disfigurement which would prevent the obtaining of any employment. Rulings covering the loss of an ear are on hand from three sources, the industrial accident board of Michigan and the labor commissioner of Minnesota making allowances for the mutilation, while the New York supreme court, appellate division, ruled that such an injury was neither enumerated in the schedules of the law nor did it cause disability, so that no compensation could be awarded for it. It was said, however, that the right to sue for such an injury was not affected by the statute, it not being 'included under it, so that an action at common law would lie. (Shinnick v. Clover Farms Co., 154 N. Y. Supp. 423.) The supreme court of the State in special term in a later case (Connors v. Semet-Solvay Co., 159 N. Y. Supp. 431), rejected this view and allowed compensation for burns causing disfigurement and pain, saying that no recovery could be had apart from the compensation act, holding that the compensation law covers all points of the employer's liability, and citing the court of appeals of the State (Jensen v. S. P. Co.) as authority.

Accidental injury as proximate cause.-Where the laws are construed as applying only to cases of accidental injury, using that term in its customary significance, there is great difficulty in determining the proximate cause of the physical conditions for which claims are submitted; i. e., whether or not the causal connection between the condition and the alleged happening back of it is such as to support a claim. It is a common rule that where, on account of preexisting conditions, as of varicose veins, hardening of arteries, or incipient or latent tubercular, cancerous, etc., conditions, the employee is peculiarly liable to serious results from comparatively slight injuries, “the employer takes his employee subject to the physical conditions he is in at the time he enters the employment "; 1 and even though the injury was in reality but an aggravation of existing conditions, compensation must be paid where the injury actually caused the disability of a person otherwise able to continue in employment. This rule is followed by the California industrial commission, but

1 Decisions, Industrial Accident Commission of California, vol. 2, p. 525.

in a case in which recovery from ulceration and varicose veins was prolonged by reason of a previous ulceration which had destroyed the true skin and left only a scar tissue of slow healing capacity, the period of compensation was restricted to an estimated period ordinarily required for recovery from varicose ulceration. The Ohio Industrial Commission allowed full benefits for the death of a man who was predisposed to apoplexy, a stroke having been induced by overexertion in the course of his employment. A ruling by the Massachusetts board on review awarded total-incapacity benefits in the case of a man to whom an injury had caused aggravation of an old arthritis of the spine, recovery from the injury being interfered with by habits of regular drinking which affected "circulation, heart, blood vessels, liver and kidneys. It will be a tremendously long time before such a spine becomes normal. The accident is responsible for taking two or three years out of the man." The same board, however, determined that the general physical condition of another employee would have incapacitated him in any event within approximately one year after the date of the injury which effected his disability, and payments were limited to that period; and a Minnesota county court decided that the condition of a miner's eye was such prior to the injury that it would have become useless in 67 weeks, so that compensation should be limited to the period thus fixed, where the injury resulted in the blindness of the affected eye. (Pintar v. Morton Mining Co.) This corresponds to the action of one of the compensation commissioners of Connecticut in estimating the period of probable capacity to remain at work of an injured man who was afflicted with a progressive disease at eight weeks beyond the date of his injury, limiting the award for compensation to that period.

It seems impossible to reconcile these rulings with another ruling of the Massachusetts Accident Board in which compensation for the full term was awarded a widow for the death of her husband from apoplexy following heavy lifting. It was found that the man had previously suffered from advanced arteriosclerosis, Bright's disease, and heart trouble, and "probably would not have lived a year if he had not been injured." In making this ruling, however, the board cited two decisions of the supreme court, In re Fisher (108 N. E. 361) and In re Brightman (107 N. E. 527), in both of which the statutory allowance was made for the death of employees who were affected by weakness of the heart and succumbed after exertion which would probably not have produced any serious results in the case of a person in normal physical condition. That this is definitely the position of the Massachusetts supreme court appears from the following, quoted from a very recent opinion handed down by it (In re Madden, 111 N. E. 379, Feb. 7, 1916): "There is nothing said in the act about the protection being confined to the healthy employee. The

previous condition of health is of no consequence in determining the amount of relief to be afforded. It is the injury arising out of the employment and not out of disease for which compensation is to be made. Yet it is the hazard of the employment acting upon the particular employee in his condition of health and not what the hazard would be if acting upon a healthy employee or upon the average employee. All who rightly are describable as employees come within. the act." (See also Crowley v. City of Lowell, 111 N. E. 786; accident to a man having dormant syphilis resulted in insanity.) The industrial commissioner of Iowa, in discussing a case in which there was a syphilitic condition which presumably doubled the period of disability, ruled that there was nothing found in the law which justified taking this difference into consideration, saying, "It is my opinion that in Iowa compensation must be paid for the entire period of disability and that you should not take into consideration the physical defects." 1

The Supreme Court of Michigan took the same view as that expressed by the Iowa court in a case (Hills v. Oval Wood Dish Co.,

1 The provisions of the laws vary in regard to any limitation in this field, but they generally undertake to exclude diseases not the result of injuries in the employment, the. law of Kentucky excluding also "the results of a preexisting disease," though just how this exclusion will work out in the administration of the act remains to be seen.

An obvious necessity for safeguarding the situation in this respect is the examination of applicants for employment, and it has been suggested that this duty be performed by the State so as to enable such distribution or employment of impaired workmen as will best avoid their being entirely deprived of opportunity for self-support. The Industrial Commission of Ohio has a special bulletin on this subject (Physical Examination of Wage Earners in Ohio, 1915), giving an account of results of examinations of applicants and employees in establishments employing some 68,000 persons. An Executive order of President Taft, date of Dec. 7, 1912, covering "all artisan and supervisory artisan positions under the jurisdiction of the Department of the Navy" under the competitive classified service, contains the following:

"No artisan or supervisory artisan whose position is included in the classified service by this order shall be. classified unless he has established his capacity for efficient service or has been examined and found qualified by the labor board and is recommended for classification by the commanding officer under whom he is employed."

In accordance with the foregoing, instructions were drafted by the Civil Service Commission in 1914 barring applicants from examination who are affected by insanity, tuberculosis, paralysis, epilepsy, blindness, loss of both arms or both legs, loss of arm and leg, badly crippled or deformed hands, arms, feet, or legs, uncompensated valvular diseases of the heart, locomotor ataxia, cancer, Bright's disease, or diabetes. Ratings were also adopted showing deductions for the impairments named ranging from 5 per cent to rejection.

Besides the rejections named, contagious or infectious disease (including venereal) and arterio sclerosis were added. Deductions from 30 per cent to rejection were directed in case of loss of hand or foot, or hernia; from 15 to rejection for piles, fistula, or fissure, and for deformities, old fractures, etc.; from 10 to rejection for chronic disorders of stomach or bowels; and from 5 to rejection for rheumatism or history of it. Also deductions of 30 per cent for valvular disease of heart fully compensated, as attested by certificates of two physicians; 15 for loss of eye, middle ear disease, or deafness; 15 to 30 for spinal curvature, loss of one or more fingers or toes; 10 to 25 for enlarged heart (unaccompanied by valvular disease) or irregular heart; 5 to 30 for varicose veins; 5 to 25 for skin diseases (noncontagious) and chronic bronchitis; 5 to 15 for chronic tonsilitis or pharyngitis; 5 to 10 for varicocele, minor defects of vision, deficient chest mobility, insufficient muscular development, obesity, too rapid heart, or deviation of nasal septum, cleft palate, etc.

A rating of at least 70 per cent on physical ability is required for all positions filled through noneducational examinations.

158 N. W. 214) involving similar conditions. It was said that assuming that the disability was in fact prolonged by the disease, there was yet no point at which it could be said that the consequences of the injury ceased to operate, the claim being indeed that the consequences of the injury were prolonged rather than that they ceased to have effect. "There is no part of the period of disability that would have happened, or would have continued, except for the injury.” Compensation was therefore to be continued during the whole term of disability.

That appendicitis was the result of a blow on the walls of the abdomen, and compensable under the act, was the ruling of the accident board of Maine, the injury following a fall against an object near the injured man's working place, the floor being slippery with oil. A Connecticut commissioner made a full award in the case of a man suffering from appendicitis, the appendix being ruptured by a strain, resulting fatally; and so of an award affirmed by the Supreme Court of New Jersey, where an internal cancer was ruptured by effort while at work, with fatal results, the court saying "but for the injury, life might have continued for a considerable period" (Voorhees v. Smith Schoonmaker Co., 92 Atl. 280); while the California commission held that the fatal consequences of a perforation caused by gastric ulcer following an effort in cranking an automobile was not compensable, as the effort was only the occasion of the injury, and not the cause. An unusual situation developed in the case of a Connecticut employee who had practically lost the sight of an eye previously, but received an injury necessitating its removal. The award made was for the period of total disability and for medical, surgical, and hospital services prescribed by the law, and not for the loss of an eye. The administrative bodies of Michigan and Wisconsin ruled similarly in opposition to claims where workmen fell as the result of illness and injured themselves by so falling, the Michigan board saying that "The employer is not liable for injury due to illness rendering the employee incapable of properly guarding himself against injury"; while the Wisconsin commission declared that "Such injuries are not subject to compensation unless they result from unusual physical conditions.” The New York commission, on the other hand, awarded the regular benefits in a case in which an employee fell in a fit of apoplexy and was burned by a pail of hot tar which he was carrying. In a case in which a fall while at work apparently lighted up a latent infection, the Wisconsin commission allowed a claim for resultant disability.

Questions of proximate cause were passed upon by the courts of a few States, the Supreme Court of Massachusetts sustaining an award in the case of death from suicide following insanity, the employee having had his eye burned from a splash of molten lead, the court saying that if the injury arose out of and in the course of employ