An Investigation into the Nature of Black Phthisis | Page 4

organs,
must be an atmosphere thickened by such a sooty exhalation.
It is now known, that this disease originates in two principal causes,
viz., First, The inhalation of lamp smoke with the carbonic acid gas[3]
generated in the pit, and that expired from the lungs; Second, Carbon,
and the carburetted gases which float in the heated air after the
ever-recurring explosions of gunpowder, which the occurrence of trap
dykes renders necessary.
To those acquainted with mining operations, an explanation of the coal
and stone hewing process is unnecessary; but, for the sake of the
uninitiated, I may be allowed to state, in explanation, that, previous to
any coal hewing, it is needful to remove various strata of stone, to open
up road-ways, and break down obstructing dykes, by the aid of
gunpowder. All coal-miners are engaged exclusively with one or other
kind of labour; that is either in removing stone or coal: and the peculiar
disease to which each class is liable, varies considerably, according to
the employment. For instance, the disease is more severe and more
rapid in those who work in the stone, than in those engaged in what is
strictly coal-mining, while, at the same time, both ultimately perish in
consequence of it. The fact of the disease being more acute in
stone-miners, I am disposed to attribute to the carbon and other
products of the combustion of gunpowder, being more irritating and
more destructive to the lungs. A very striking instance of this occurred,
a few years ago, at the colliery of the Messrs Cadell of Tranent. A very
extensive coal level was carried through their coal field, where a great

number of young, vigorous men were employed at stone-mining, or
blasting, as it is called, every one of whom died before reaching the age
of thirty-five years. They used gunpowder in considerable
quantity:--and all expectorated carbon.
It was long a very general belief with medical writers, that the various
forms of discoloration in the pulmonary tissue was induced by some
peculiar change taking place in the economy or function of secretion,
independently of any direct influence from without. They were,
therefore, usually supposed to belong to the class of melanotic
formations, from presenting, as their distinguishing feature, a greater or
less degree of blackness. But, by recent investigations, it has been
proved, that the infiltrated carbon found in the bodies of coal miners is
not the result of any original disease, or change taking place within the
system,[4] but is carbon, which has been conveyed into the minute
pulmonary ramifications, in various forms, during respiration; and
which, while lodged in these tissues, produces irritation, terminating in
chronic ulcerative action of the parenchymatous substance. The very
minute bronchial ramifications first become impacted with carbon, and
consequently impervious to air; by gradual accumulation, this impacted
mass assumes a rather consistent form, mechanically compressing and
obliterating the air-cells, irritating the surrounding substance, and
promoting the progressive extension of the morbid action, till the whole
lobe is infiltrated with carbonaceous matter, which, sooner or later,
ends in ulceration and general disorganisation of the part. It is evident,
in tracing the disease through its various stages, up to that of
disorganisation, that wherever there is an impacted mass in any part of
the pulmonary structure, this is followed, sooner or later, by softening,
from its irritating effects upon the tissues by which it is surrounded;
and as this softening process advances, the innumerable sets of
vessels[5] composing the dense network of capillaries are broken down,
extending the cyst, so that, as the cysts enlarge, they gradually
approximate to each other, till all at last become merged in one great
cavity.
The majority of colliers, soon after they engage in their mining
operations, become afflicted with bronchial disease to a greater or less

extent.
Those who are hereditarily predisposed to pulmonary irritation, are, it
is my decided belief, more liable to "black phthisis" than others; but I
cannot suppose it possible, that any constitution, however robust and
sound, could resist the morbid effects resulting from carbon deposited
in the lungs. Tubercular phthisis is not at all prevalent in any collier
community with which I am acquainted, only occasional cases
occurring, and that amongst females. It is my impression, that a
phthisical person, engaged in the operations of a coal-pit, similar to
those in Haddingtonshire, would come under the influence of the
carbonaceous disease, instead of the true phthisis; for, in all the
post-mortem examinations which I have conducted, connected with this
pulmonary affection, I have never found tubercular deposit:--while
other members of the same family, having a like predisposition, and
who never entered a coal-pit, have died of phthisis. Can carbon inhaled
destroy a tubercular formation? I never knew or heard of a case of
black spit in a female collier, and this