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.
Table of contents (by pages)
- 1: An Investigation into the Nature of Black Phthisis
- 2: In an article on Spurious Melanosis
- 3: My present remarks do not refer to coal miners in general
- 4: There is a much freer action of the respiratory apparatus
- 5: Ends in ulceration and general disorganisation of the part
- 6: Lose to a certain degree this secretory power
- 7: As the carbonaceous impaction advances
- 8: Eight expectorated carbonaceous matter
- 9: Which was expectorated without difficulty
- 10: By the simple process of diluting the sputa with water
- 11: And to be felt through the pleura
- 12: He removed from Airdrie to the coal work at Preston Hall
- 13: In repeated examinations with the stethoscope
- 14: That at some points the pleura pulmonalis
- 15: In tracing the bronchi from the lungs to the bifurcation
- 16: From his feeling of dyspnoea and thoracic oppression
- 17: The indurated nuclei were ascertained to be impacted lobules
- 18: With tough mucous expectoration
- 19: Found in the cavities of the pleura
- 20: And while labouring at Penston
- 21: Penston coal work is exceedingly well ventilated
- 22: Several small carbonaceous cysts throughout its substance
- 23: The pleura pulmonalis was much thickened and rough
- 24: The carbonaceous expectoration became more copious
- 25: Ascites and general anasarca were considerable
- 26: While other parts formed cysts
- 27: And thereby producing painful dyspnoea
- 28: Both pleurae were much thickened
- 29: This man laboured at Pencaitland coal work
- 30: I ordered soothing expectorants
- 31: On the coaly matter in the bronchial glands
- 32: The melanotic matter is easily effaced by washing
- 33: If the tubercular affection was not cured
- 34: Written by Dr Brockmann of Clausthal
- 35: Dyspnoea is usually connected with the cough
- 36: And established in the parenchyma of the lungs
- 37: But many of the Penston colliers
- 38: My object in here reporting a case of stratiform melanosis
- 39: While of the contents of the melanotic cyst
- 40: 14 This sputum was subjected to the action of nitric acid
- 41: Through the kindness of Mr Girdwood
