In the industrializing South, health and medicine lagged far behind, and textile mill workers faced serious dangers both on the job and in mill villages. Without antibiotics, infectious diseases were common, medical care was often unavailable, and employers were not required to provide health insurance or worker compensation. In mill jobs such as the opening and card rooms, constant cotton dust and lint caused coughing, lung irritation, and over time brown lung disease, or byssinosis. In weave rooms, persistent heat and humidity contributed to tuberculosis and other respiratory disorders. Machinery could also maim or kill, as workers’ hands or arms were caught in belts and one man was thrown to the top of the mill and killed. Even without major accidents, long hours of repetitive labor brought continual soreness and fatigue, while filthy conditions inside mills helped spread disease. Life in mill villages brought further health risks because most residents lacked indoor plumbing and running water, shared wells and outhouses, and lived in crowded conditions that encouraged flies to spread typhoid and dysentery. Poor diets lacking essential nutrients also led many to pellagra, which caused skin, digestive, and nervous disorders and could be fatal. In 1916, pellagra affected 16% of mill village households. Because laws did not require owners to care for injured or sick workers, those disabled by illness or accident depended largely on collections, food, and other aid from neighbors within the mill community.