was slow when compared to its former state. The
pulse not beyond 45 in the minute. By the end of this year he appeared
in a half dead state,--but a mere shadow in regard to flesh. He was
expectorating at intervals of some weeks, when the cough became more
severe, a few carbonaceous sputa, and suffering severely from gastric
irritation.[13] During the last week of his life, he expectorated
considerable quantities of black fluid, and died exhausted, January
1837.

_Post-mortem examination_, which was conducted hurriedly, exhibited
extensive effusion into both sides of the chest. The adhesions of the
pleura were strong, and evidently of long standing. There was very
general carbonaceous infiltration throughout the lungs, without
excavations to any extent. Various empty cysts, which could contain a
hazel-nut, were found in the superior and middle lobe of the right, and
throughout the whole of the left lung; in which bronchial twigs
terminated. The pericardium was distended, with limpid effusion. The
right side of the heart was dilated, and filled with dark
treacly-looking blood; and when washed, it appeared pale and bloodless.
Its walls were thin, various patches of brown exudation extending over
both pleurae. There were several enlarged lymphatic glands, found at the
root of both lungs, filled with black fluid.

In examining the head, the pia mater was found much congested; but there
was no effusion discovered into any of the ventricles of the brain, nor
any other indication of disease.

In tracing the history of this patient, connected with the disease, it
will be observed, that until he came to Pencaitland colliery, he had no
symptom whatever of chest affection. Penston coal-work is exceedingly
well ventilated, and the miners who labour there seldom, if ever, suffer
from the black expectoration, owing to the evolved smoke of every kind
being freely carried off from its underground works, while it is quite
the contrary at Pencaitland, where many colliers, on leaving Penston,
are seized with the disease. This case comes under the second division
of the disease, where the irritative process, the result of the foreign
matter in the lungs, has proceeded so far as to produce a variety of
small cysts, containing fluid, or semi-fluid carbon, following the
course of the bronchial ramifications.

* * * * *

CASE 6. D. L., aged twenty-six years at his death, in August 1837. He
was the son of a c