On anthracosis or coal-miner's phthisis : the spurious melanosis of Carswell / by J. Warburton Begbie.

  • James Warburton Begbie
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: On anthracosis or coal-miner's phthisis : the spurious melanosis of Carswell / by J. Warburton Begbie. Source: Wellcome Collection.

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    of destruction of the pulmonary substance in anthracosis, may have such significant physical signs as cavernous breathing, gurgling rale, and pectoriloquy to distinguish it, and these quite as well marked as when we meet with them in the advanced stages of tubercular disease. This will not always hold true, for the disease we have to deal with, an eminently chronic one, is specially apt to be attended by intercurrent pleural inflammations. Hence, pleural thickenings and dense adhesions, common enough in tubercular consumption, are still more so in anthracosis. It is probably owing to the chronic nature of the disease, but specially from the frequency of pleural inflammation and adhesion, that the occurrence of pneumo¬ thorax has not been observed in cases of carbonaceous infiltra¬ tion of the lungs. The appearance presented by the lungs when affected by anthracosis is very remarkable. The colour varies from a well marked slate-colour, to a deep, almost jet, black. The external surface usually resembling more exactly the former, while the cut surface presents the darker hue. If the lung is in the early stage of the disease, no excavations having formed, it is volumi¬ nous, of increased density, evidently condensed from the occupa¬ tion of the parenchymatous structure by black pigmentary matter. If subjected to pressure a considerable amount of fluid, dark in colour, flows out, staining in a remarkable manner the hands. So deep is the stain thus caused that it generally requires several applications of soap and water thoroughly to remove it; certain parts of the lungs are generally found to be denser, and the tissue in these more completely occupied by carbonaceous matter than others. A portion of such will readily sink in water, communicating a deep black colour to the water as it passes down through it. Unlike the deposition, of tubercular matter which usually commences in the apex, or towards the summit of the lung, this black matter is found equally to invade all portions—the base is as subject to it as the apex. Nor is one lung more likely to be affected than the other; they suffer equally. This experience in regard to car¬ bonaceous infiltration, so opposed to what holds true of tuber¬ cular deposition in the lungs, seems again to favour the view of the former being in the first instance, whenever it occurs, due to direct inhalation of minute particles. Were it otherwise, is it not reasonable to suppose that, as is commonly the case with tubercular deposition, the apices of the lung would chiefly suffer, and one lun^ mia;ht be found much diseased, while the other was comparatively unaffected? It seems to have been at one time imagined that the car-
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