I have long entertained the belief, which I have stated in another part of this essay, that if the carbon is once conveyed into, and established in the parenchyma of the lungs, that organ commences the formation of carbon; thus increasing the amount originally deposited. Dr Brockmann sets forth, as grounds for this view, that "if the parenchyma of the lungs were filled with carbonaceous dust, their specific gravity ought to be increased; but this is not the case. A completely melanosed lung swims in water, both as a whole and when cut into parts." It is very evident from these remarks, that the author has not seen the disease as it is exhibited in the third division of morbid action in the collier, otherwise he would have both observed the lungs considerably augmented in weight, and also so densely impacted from the accumulation of carbon, as wholly to sink in water. See for instance case No. 2, where the lungs weighed about six pounds, and parts of the cellular tissue were so indurated, as to be cut with difficulty. In this case, the patient did not expectorate.
Dr Brockmann, as he advances, puts a question here, which more fully shows that the disease under his consideration was of a mild character compared with that under our notice. "If," says he, "pulmonary melanosis arise entirely from inhalation of carbonaceous dust, why is it not observed in other workmen, who are as much, and even more, exposed to its influence, as for instance, smelters, or moulders, and colliers?" He says, further, "were the carbon inhaled in quantity sufficient to explain the black colour of the lungs, it ought also, from its mechanical irritation, to produce inflammation in the delicate mucous membrane of the organ, but there are no symptoms of this during life, nor any traces of it after death." An answer to these remarks will be most satisfactorily given by a reference to the published cases, where the disease is principally found amongst colliers and moulders, and where the pulmonary organs, particularly in the former, are found to undergo most fearful disorganization from the presence of carbon. It is very remarkable, that the author of these exceedingly interesting observations should never have found excavations of the parenchyma, when it is so general as the result of the same disease in this country, particularly in the locality to which I refer. Not knowing the character of the mine, it is impossible to judge; but I am disposed to conclude that there cannot be the same quantity of carbon floating in the atmosphere breathed by the German miner,—the disease resembles very much that milder form found in the iron moulder.
With regard to the carbonaceous state of the blood, I am sorry that I have not yet completed my investigations on that subject. It is still my belief that the carbon being once inhaled, there is an affinity found for that in the circulating fluid, and from its not being consumed, owing to a deficiency of oxygen, there is a progressive increase going on. I am very much gratified to find that Dr Brockmann entertains a somewhat similar opinion in respect to the state of the blood.
The effects of such a morbid structure upon the collier population in general is very marked. Previous to the late legislative act, the tender youth of both sexes were at an early age consigned to the coal pit, and obliged to labour beyond their feeble strength, in circumstances ill adapted to their years. Such early bodily exhaustion soon produced in them a pallid countenance, soft and relaxed muscular fibre, and predisposed much to disease as they advanced in life. The miner on this account was generally from his youth, thin; in fact, you never see a fat and healthy-looking collier, and, according to the advance of pulmonary disease, with them, so is the progress of emaciation. Such a state of body may well be looked for in miners, labouring as they do, from ten to twelve hours in the twenty-four under ground, breathing a heated and impure atmosphere, which with difficulty sustains life, and which is demonstrably calculated, from its deleterious qualities, to induce serious disease. The effects manifest in the parent descend, and visible in the youngest children; they are squalid and wretched-looking,—and how can such offspring be otherwise? They are exceedingly subject to all children's diseases, and peculiarly predisposed to pulmonary irritation of one kind or other.
With regard to medical treatment, little can be done after the disease has passed its first stage. Early removal from the occupation, and proper attention to nutrition, alone seem to hold out the hope of prolonging the life of the patient; but if there be carbon lodged in the pulmonary tissues, there is a certainty of its sooner or later proving fatal. Attention to the state of the digestive organs, and using every means to remove the dyspeptic symptoms, which are prominently present throughout the various stages of this disease, are indispensably requisite; and, as to nutrition, the nature of the diet should be as generous as possible. Anodynes and expectorants are the only remedies which seem at all efficacious in allaying irritation.
With a view to remove urgent symptoms, venesection has repeatedly been had recourse to, but in almost all instances I would say, with decidedly bad effects. Blood-letting does harm, producing general debility and rapid sinking.[25]
With regard to the prevention of this disease, ventilation, as has been stated, is very much neglected in the pits now under consideration, where the various cases have occurred; and to that neglect I ascribe the prevalence of the malady. In those pits referred to, the workable apartments are so confined, and become after a time so destitute of oxygen, as, along with the smoke from lamps and gunpowder, to render the air unfit for healthy respiration. The only effectual remedy is a free admission of pure air, so applied as to remove the confined smoke. This remark both applies to coal and stone-mining. The introduction of some other mode of lighting such pits than by oil is required. I know several coal-pits where there is no carbonaceous disease, nor was it ever known; and on examination I find that there is and ever has been in them a free circulation of air. For example, the Penston coal-work, which joins Pencaitland, has ever been free from this disease; but many of the Penston colliers, on coming to work at Pencaitland, have been seized with, and died shortly after, of the black spit: for instance, G. case No. 5, and D. case No. 8, are such.
How this is to be accomplished, is for the scientific man to say. With all due deference, I may be allowed to suggest various modes which might be adopted to free the underground atmosphere of the noxious ingredients. Could fresh air not be forced down by the power of the steam-engine, which is at every coal-pit? Could extensive fanners not be erected and propelled by the same machinery?[26] I am much surprised that no attempt has been made to light these pits with portable gas in some way or other. As far as I can understand, such an application of it would not be difficult. A small gasometer could be erected, and the necessary apparatus procured at little expense, and by such means, I would suppose, it could be carried to any part of the mines, which are not extensive.
Many proprietors may grudge the expense involved in such improvements, and thus prove a barrier to these necessary alterations; but I would ask any candid and generous mind, what is expense when the object in view is the removal of a disease to which many human beings fall a sacrifice?[27]
It must appear to every one that these collier diseases are crying evils, the preventive of which is based, as will be seen, on thorough ventilation; and in order to protect the miner, there should be a vigilant attention paid to the economy of underground works. No one need be surprised at the result of such a noxious atmosphere; and it becomes a duty with the government to protect these poor people by laws, and to adopt those measures which are best calculated to preserve their health; and should there arise difficulties of an insurmountable character in the ventilation of these pits, why continue the mining operation in such situations at such a sacrifice of human life?[28]