Toms River by Dan Fagin Page A

was responsible for eighty-three villages, which he set about visiting, traversing the mountain roads via horse and buggy and occasionally on foot. At thirty years old, he was already a man of the world, having trained in Dresden and Leipzig and fought theFrench as a battlefield surgeon in the Saxon Army. 5 He was appalled by what he saw in the villages and mines of the Erzgebirge. “As a rule,” he later wrote, “the miners marry early and leave behind a large number of children in pitiful circumstances, who naturally must look for [a] line of business as soon as possible.… Like their fathers, they age quickly, and with the greatest probability face the same previous mentioned fate of their fathers.” 6
    There was one other physician in the region, Friedrich Härting. The medical officer of the largest mine in Schneeberg, Härting kept track of the number of deaths at the mine and had been quietly urging his employer to improve working conditions. To build a more persuasive case, the two physicians decided to conduct a study together to measure the prevalence of “mountain sickness” and perhaps even identify its likely cause. Like John Snow and other pioneers of the nascent field of epidemiology, Hesse and Härting attacked the problem on multiple fronts. They counted cases, autopsied dead miners (confirming for the first time that mountain sickness was, in fact, lung cancer), searched for similarities among the ill, and measured environmental conditions in the mineshafts.
    In two manuscripts, a short article Hesse wrote in 1878 and a longer one he coauthored with Härting the following year, the two physicians disclosed their findings. Between 1869 and 1877, they reported, 145 of the approximately 650 miners in Schneeberg had died of lung cancer, most of them under age fifty. Excluding accidents, lung cancer accounted for 75 percent of all deaths. It was a shockingly high percentage, even compared to miners elsewhere. Clearly, the Schneeberg mines were a particularly fertile environment for lung disease and early death, but why? The doctors’ autopsies of twenty dead miners suggested that they had inhaled something highly toxic: Their lungs had shrunk to the size of two fists, were riddled with bronchial tumors, and contained almost no air. What could have done all that damage?
    Hesse and Härting tried mightily to find out, but could not. They were looking for something that was present in the Schneeberg mines but not elsewhere, since they had written to the managers of other mines and were assured that there were no lung cancer epidemicsthere. Smaltite, the arsenic-infused mineral, was their leading suspect. It was much more common in Schneeberg than elsewhere and was known to be a lung irritant. Another clue: Schneeberg miners told the two physicians that mountain sickness seemed most commonly to afflict laborers who spent their time extracting minerals, instead of blasting tunnels or doing other jobs. Since nickel and cobalt miners worked most directly with smaltite, while bismuth miners did not, the physicians tried to compare cancer rates in the two groups but were thwarted because the miners constantly changed jobs and because the smaltite dust was everywhere, even in the bismuth-mining areas. Hesse and Härting looked for other ways to make comparisons, too, including the use of wax paper dust-collectors to see if some tunnels were dustier than others and of filter-equipped facemasks to try to measure how much ore dust miners inhaled.
    In their 1879 report, however, they conceded that each of those attempts failed to pinpoint a specific cause for the cancers. After two years of investigation, they were stymied. They wrote up their inconclusive results, called for improved conditions in the mines (again, to little effect), and never again published on the subject. Härting returned to his quiet work as a mine physician, and the peripatetic Hesse moved to Berlin and embarked on what he doubtless regarded as a