The diagnosis in life of coalworkers' pneumoconiosis is based on the industrial history and the chest radiograph. The most striking complaint is excessive breathlessness on exertion. The relationship of this symptom to radiological abnormality is of practical importance in assessing compensation; in most schemes the assumption is made that if a readily diagnosable degree of pneumoconiosis is present and the man is breathless, then the breathlessness is caused by the pneumoconiosis if no other cause is apparent. This assumes a reasonably close relationship between radiological abnormality and breathlessness after allowing for the effects of age.In full reviews of the literature, Worth and Schiller (1954), and Gilson, Hugh-Jones, Oldham, and Meade (1955), conclude that complicated pneumoconiosis is a cause of moderate or severe breathlessness and the extent of the radiological abnormality relates reasonably well to the degree of breathlessness when age is taken into account.The position in the case of simple pneumoconiosis is far less certain. A number of investigators (Jequier-Doge