An Investigation into the Nature of Black Phthisis | Page 7

any other affection. He was well-formed, and robust in
constitution. A few months previous to my seeing him, he had taken to
the employment of stone-mining in the pit at Huntlaw, where he was
accustomed to labour, and soon after being so engaged, he began to
complain of uneasiness in the chest, and troublesome short cough,
quick pulse, especially at night and in the morning, for which he sought
medical advice, and was treated for bronchial affection. He continued
to prosecute the employment of stone-mining in this coal-pit so long as
his strength would permit, which was a little more than two years,
when (August 1836) he was entirely disabled, from general exhaustion.

By this time his cough had much increased, and there was considerable
dyspnoea, accompanied with sharp pain in the thoracic region, both in
walking quickly, and when lying down. Pulse 80. He expectorated
bloody tough mucus without any tinge of black matter. All remedial
means were adopted with a view to the removal of the irritation of the
chest, without producing any very decided effect. The thoracic pain
was occasionally subdued, but the cough became incessant; loss of
appetite, rapid emaciation, and cold nocturnal sweats, with slow weak
pulse, supervened. After a severe fit of coughing, during one of his bad
nights, the black expectoration made its appearance, in considerable
quantity, by which his sufferings were for a few days alleviated, when
the cough returned in the same degree of severity, and was again
mitigated by the black sputa, which was expectorated without difficulty,
and from this time (October 1836) there was no interruption to a free
carbonaceous expectoration.
In the early part of this man's illness, the stomach, the alimentary canal,
biliary and urinary secretions, continued unimpaired; but as the cough
advanced, gastric irritation, which was followed by vomiting during the
paroxysms, annoyed him; and for the last eight months of his life, he
suffered occasionally from severe attacks of gastrodynia, which, when
present, had the effect of considerably modifying the thoracic irritation,
and allaying the cough. There was nothing very remarkable in the
character of the urine; the quantity voided was small, and very high
coloured, with occasionally a lithic deposit. The fæces were natural,
and smeared with dark blue mucus. On examining the chest with the
stethoscope, the crepitant ronchus was heard in the upper part of each
lung. There was general dulness throughout the lower part of both, with
the exception of a small space at the inferior angle of the left scapula,
where pectoriloquy was distinctly heard, from which was concluded the
cavernous state of a portion of that lung. The heart's action was languid,
and often intermitting, producing vertigo and occasional syncope. The
pulse was gradually becoming slower; and at this time, (Nov. 1836,) it
was forty-three in the minute. I was informed by this man, that his
chest affection first became manifest, after being engaged with a
difficult job in a newly formed coal-pit at Huntlaw, where he had very
little room to conduct his mining operations, which were carried on

with the help of gunpowder, and where he experienced a sensation of
suffocation from the confined nature of the pit,[7] which did not permit
of the exit of the evolved carbon, and ever after, his cough and
difficulty of breathing had been increasing rapidly. During the greater
part of the period he was under my charge, he continued to expectorate
black matter, of the consistency of treacle, mixed with mucus in
considerable quantity, and I would suppose, taking the average of each
week, that he expectorated from ten to twelve ounces daily of thick
treacle-like matter. I had the curiosity, during my attendance on this
patient, to separate the mucus from the carbon, by the simple process of
diluting the sputa with water, and thereafter separating and drying the
precipitated carbon. I was enabled by this means to procure about one
and a-half drachms of a beautiful black powder daily, and in the course
of a week, I had collected near to two ounces of the substance. This
process I continued for some weeks, till such time as I had procured a
sufficient stock of this remarkable product of the pulmonary structure,
and I am certain that the same quantity, if not more, could have been
obtained till his death, in Dec. 1836. It is undoubtedly a striking
phenomenon, connected with the pathology of the chest, that the human
lung can be converted into a manufactory of lamp black!
Towards the close of this poor man's existence, the countenance and
surface of the body assumed a leaden hue, from the very general
venous congestion, and as his system became more exhausted, and he
was about to sink in death, the gastric irritation and nocturnal cold
sweats which had been long present