Historical perspectives in occupational medicine. Pancoast and the image of silicosis

In the two decades following the First World War, American occupational medicine was consumed in cataloguing the pneumoconioses, and no physician was more prominent than Henry K. Pancoast of the University of Pennsylvania. In a landmark trial following the worst silicosis outbreak in the United States at Gauley Bridge, West Virginia, Pancoast testified for the defense, attributing the disease to tuberculosis. Pancoast was not an isolated commentator, as the prominence of the cases attracted some of the country's leading authorities on occupational medicine. Pancoast's error, as well as the accuracy of some of his colleagues, clarifies an important occupational disease in its epidemic period. There is also a less historically specific exposition of the impact of professional involvement in social policy, liability, and compensation.