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

  • James Warburton Begbie
Date:
1882
Catalogue details

Licence: Public Domain Mark

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

    18/70 page 256
    ■256 sound, and even cavernous rfile, are, in some cases quite as readily recognised iu the one condition as in the other. So, also, when softening and excavation have occurred, the moist sounds, the crepitant and sub-crepitant rale, and the coarser gurgling will be audible in anthracosis just as in phthisis. It is consistent with ray own observation, and the two cases which have been shortly detailed will bear out the remark that a vomica, the result of softening, and ultimately of destruction of the pulmonary substance in anthracosis, may have such signifi- cant 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 infiltration 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 voluminous, of increased density, evidently condensed from the occupation 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 remark- able 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 gener- ally 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
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