1836. It is
undoubtedly a striking phenomenon, connected with the pathology of the
chest, that the human lung can be converted into a manufactory of lamp
black!

Towards the close of this poor man's existence, the countenance and
surface of the body assumed a leaden hue, from the very general venous
congestion, and as his system became more exhausted, and he was about to
sink in death, the gastric irritation and nocturnal cold sweats which
had been long present with him considerably increased, along with a
cough so severe as actually to produce vomiting of the black sputa. His
tongue and fauces became so coated with the expectoration, that a
stranger viewing the patient would have said that he was vomiting black
paint.[8]

This case resembled in many of its features, one of tubercular phthisis,
more than is generally found in the disease before us, there being cough
and expectoration, dyspnoea, sharp pain in the thoracic region,
colliquative sweats,[9] and great emaciation, while at the same time,
the pulse was slow and weak, not exceeding thirty-six in the minute for
a week before death. No hectic heat of skin, but an extraordinary
depression of the arterial action, arising evidently from the redundancy
of carbon deposited in the pulmonary tissue, preventing the proper
oxygenation of the blood circulating in the organs, and thereby
producing a morbid effect on the whole system, which sufficiently
explains the cachectic condition of the body.

_Post-mortem examination, twenty-four hours after death._--In removing
the anterior part of the thorax, the lungs appeared full and dilated,
and of a very dark colour. Both lungs were strongly attached to the
pleura costalis, and a very considerable effusion of straw-coloured
fluid was found in both cavities of the chest. A few irregularly
situated dark glandular bodies were observed on the surface of the
costal pleura at each side of the sternum, and on the mediastinum. The
lungs were removed with difficulty on account of the strongly adhesive
bands attaching them to the ribs, and in handling them they conveyed the
impression of partial solidity:--several projecting, irregular firm
bodies, were felt immediately beneath the surface of the pleura, and
there was also present emphysematous inflation of the margins of the
upper lobes. In transecting the upper lobe of the left lung, it was
found considerably hollowed out, (to the degree of holding a large
orange,) and containing a