An Investigation into the Nature of Black Phthisis | Page 9

was healthy. The gall-bladder was empty, and the spleen
large and congested. The stomach was smallish and empty. The
mucous membrane was smeared with a blackish, tenacious fluid, which,
upon removal, appeared to be a portion of the expectoration. The
structure, as far as could be ascertained, was healthy. The small and
great intestines contained fluid carbon (evidently swallowed), while no
disease was manifest. The mesenteric glands were small and rather firm,
but they contained no black matter; the mesentery was much congested
with dark venous blood. The kidneys were apparently healthy, though

soft. The bladder was small and contracted. The head was not examined,
as I expected nothing but general congestion of the vessels.
This case comes under the third division of the disease, where the lungs
were cavernous, and where there was free expectoration of carbon.
CASE 2. The following case is one of unsuspected carbonaceous
accumulation in the lungs, the history of which proves the fact, that the
disease, when once established in the pulmonary structure, continues to
advance till it effects the destruction of the organs, although the patient
has not been engaged in any mining operations for many years previous
to his death.
Robert Reid, aged forty-six at his death, had been a collier since his
boyhood. He was a short, stout-made man, of very healthy constitution,
and never knew what it was to have a cough. He spent the early part of
his life at a coal-mine, near Glasgow (Airdrie), where he all along
enjoyed good health. In 1829, he removed from Airdrie to the
coal-work at Preston-Hall, Mid-Lothian, where he engaged in mining
operations; and, from the time he made this change, he dated the
affection of which he died, at the end of 1836. Two months after he
removed to Preston-Hall colliery, he was seized with bronchial
affection, giving rise to a tickling cough in the morning and when
going to bed, accompanied by dyspnoea, with a quick pulse (90), and
palpitation of the heart. In the first stage of the affection, he had no
expectoration of consequence; but soon after, a little tough mucus was
coughed up, and when it was difficult to expectorate, the sputum was
occasionally tinged with blood. At this period, the appetite continued to
be good, and the strength little impaired. During the day, he felt in his
usual health; and, therefore, he continued in full employment. At the
end of the four months (Jan. 1830), his cough had increased much, his
palpitation of heart, dyspnoea, and bronchial irritation had become very
oppressive, and general exhaustion had manifested itself. Recourse was
had at this period of the affection to bleeding, blisters, and expectorants,
which relieved him only temporarily, and while under this treatment,
he--having a large family dependent on his exertions for their
support--continued to struggle on at his daily vocation so long as he

was able to handle the pick-axe. At the close of 1832, which completed
three years of labour in this coal-mine, he was obliged to discontinue
all work, and take refuge in medical treatment, with a severe cough,
palpitation, annoying dyspnoea, small intermitting pulse, and sleepless
nights. On inquiring as to his general habits and mode of life, I found
that he had been all along a sober, regular-living man, that he never
complained of ill health till he engaged in this coal-mine at
Preston-Hall, where the work was difficult and the pit confined, he
having only twenty-four inches of coal seam which obliged him to
labour lying on his side or back.[10] He was also at this time
occasionally engaged as a stone-miner, and was consequently subjected
not only to the inhalation of the smoke of linseed oil, but to that of
gunpowder. For his chest complaint at this stage, he underwent a
variety of medical treatment, which produced mere palliation in his
symptoms, and though breathing a pure atmosphere in a country
situation, he experienced a most painful sensation of want of air, or, as
he himself expressed it, "a feeling as if he did not get enough down."
By this time the countenance had become livid, the lips and eyelids
dark and congested. After undergoing medical treatment in the country,
without much relief, he was removed to the Edinburgh Infirmary, in
July 1833, in the hope of deriving benefit; but after being a patient in
that hospital for some weeks, he returned home much worse. In
addition to the aggravation of his other symptoms, there were present
oedematous swelling of the extremities, which were generally cold and
benumbed, gnawing pain in the right hypochondriac region, and almost
total loss of appetite. On examining the right hypochondrium, which he
described as swollen, there was evident indication of an enlarged liver,
and he complained much of shooting pain in that region during a
paroxysm