An Investigation into the Nature of Black Phthisis

An Investigation into the Nature of Black?by Archibald Makellar

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Title: An Investigation into the Nature of Black Phthisis or Ulceration Induced by Carbonaceous Accumulation in the Lungs of Coal Miners
Author: Archibald Makellar
Release Date: June 23, 2007 [EBook #21907]
Language: English
Character set encoding: ISO-8859-1
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AN INVESTIGATION
INTO THE NATURE OF
BLACK PHTHISIS;
OR
ULCERATION INDUCED BY CARBONACEOUS ACCUMULATION
IN
THE LUNGS OF COAL MINERS,
AND OTHER OPERATIVES.
BY
ARCHIBALD MAKELLAR, M.D., F.R.S.S.A.,
FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS OF EDINBURGH; MEMBER OF THE MEDICO-CHIRURGICAL SOCIETY, OF THE HARVEIAN SOCIETY, OF THE OBSTETRICAL SOCIETY, ETC. ETC., AND ONE OF THE PHYSICIANS TO THE NEW TOWN DISPENSARY OF EDINBURGH.
REPRINTED FROM THE MONTHLY JOURNAL OF MEDICAL SCIENCE.
EDINBURGH:
SUTHERLAND & KNOX, 58 PRINCES STREET.
1846.

ANDREW JACK, PRINTER, EDINBURGH.

PREFACE.
An abstract of the investigations into the nature of carbonaceous infiltration into the pulmonary tissues of coal miners, was read by Dr Makellar at a meeting of the Medico-Chirurgical Society of Edinburgh, Wednesday, 8th July, 1845, Dr Gairdner, President, in the Chair.
Reference was made, in particular, to the East Lothian coal-miners. The carbonaceous disease described, was stated to be caused by the inhalation of substances floating in the atmosphere of the coal-pit, such as the products of the combustion of gunpowder, the smoke from the miner's lamp, and the other foreign matters with which the air of the mines is heavily charged, in consequence of their defective ventilation. In the mines in which gunpowder is used, the disease is most severe in its character, and most rapid in destroying the pulmonary tissue. The carbon in some cases is expectorated in considerable quantity for some time previous to death; in others, it is retained, and accumulates to a great extent in the lungs.
As the disease advances, the action of the heart becomes feeble; and the appearance of the blood indicates a carbonaceous admixture. The carbonaceous deposit seems to supersede or supplant the formation of other morbid bodies in the substance of the lungs--such as tubercle; for in individuals belonging to families in which there exists an undoubted phthisical diathesis, tubercle is never found on dissection.
The views expressed in this communication called forth the following remarks.
PROFESSOR CHRISTISON called attention to the new and important fact, of the carbonaceous matter being found in the circulating mass. He attached great importance to Dr Makellar's researches.
PROFESSOR ALLEN THOMSON remarked, that the presence of this carbonaceous matter in the blood, by no means proved, that it was formed in, or from the blood.
DR HUGHES BENNETT said, that the antagonism of this carbonaceous disease to tubercle, was a fact of great interest and importance, especially in connection with two other recent observations; viz. 1st, That the depositions of carbon in the lungs of old people, (which French pathologists describe,) are not found associated with tubercle; and, 2d, That under the supposed cicatrices of pulmonary tubercular cavities, a layer of carbonaceous matter is commonly found.
Dr Makellar's paper called forth some interesting observations from the President, Professor Simpson, and others.

BLACK PHTHISIS,
OR
ULCERATION INDUCED BY CARBONACEOUS ACCUMULATION IN THE LUNGS OF COAL-MINERS
Among the many diseases incident to the coal-miner, none come oftener under medical treatment, than affections of the respiratory and circulating organs. While the collier is subject--during his short but laborious life--to the other diseases which afflict the labouring classes in this country, such as inflammations, fevers, acute rheumatism, and the various eruptive diseases, he, at last, unavoidably, falls a victim to lesions within the cavity of the chest, arising from the nature of his employment. In the present communication, it is proposed to lay before the profession a series of remarks, which I have been enabled to put together, with a view to elucidate the cause and progress of that very peculiar pulmonary disease, incident to coal-miners, which I shall denominate BLACK PHTHISIS, or Ulceration induced by Carbonaceous Accumulation in the Lungs.
The rise and progress of the malady may be thus sketched: A robust young man, engaged as a miner, after being for a short time so occupied, becomes affected with cough, inky expectoration, rapidly decreasing pulse, and general exhaustion. In the course of a few years, he sinks under the disease; and, on examination of the chest after death, the lungs are found excavated, and several of the cavities filled with a solid or fluid carbonaceous matter.
During the last ten years, my attention has