Caisson disease during the construction of the Eads and Brooklyn Bridges: A review

The Eads Bridge (St. Louis) and the Brooklyn Bridge (New York City) were testing grounds for caisson construction. These caissons were enormous compressed air boxes used to build riverine piers and abutments anchoring the bridges. Caisson meant faster and cheaper construction, but there was a hidden cost---caisson disease (decompression sickness). Within caissons, workers labored at pressures as high as 55 psig and caisson disease was common. This discourse is a brief history of the caisson, a brief discussion of the illness as viewed in the mid 1800's, and an abbreviated history of the Eads and Brooklyn Bridges. It also provides a detailed description and evaluation of the observations, countermeasures, and recommendations of Dr. Alphonse Jaminet, the Eads Bridge physician, and Dr. Andrew Smith, the Brooklyn Bridge physician, who published reports of their experience in 1871 and 1873, respectively. These and other primary sources permit a detailed examination of early caisson disease and Jaminet's and Smith's thinking also serve as good examples from which to study and learn.