_Post-mortem examination._--On examining the body, the chest was large
and well formed. The effusion into the cellular substance was very
general. The cartilages of ribs were ossified, and both lungs were
adhering strongly to the pleura costalis. There was large effusion into
both cavities of the chest, to the extent of three English pints in
whole. The pleura pulmonalis was much thickened and rough, with false
membrane, and many patches of puckering. Several lymphatic glands in the
anterior part of the mediastinum contained black fluid. The left lung
was carbonaceous throughout its substance. The upper lobe partially
excavated and ragged; the inferior lobe infiltrated and emphysematous.
The right lung was of corresponding black appearance. The lower lobe had
a firm and condensed feel, and when divided, exhibited a mass resembling
indurated blacking. The middle lobe was in part permeable to air; and
there were several small cysts containing liquid carbon, connected with
minute bronchial ramifications. Various indurated knotty bodies were
extended throughout its substance. In the upper lobe, the carbon was
confined principally to the interlobular cellular tissue, and when
pressed in the hand, gave out thick, black, frothy serum. The mucous
membrane of bronchial divisions, when freed from the black matter, was
swollen and eroded as far up as the bifurcation of the trachea. At
several parts these passages were considerably contracted.
The heart was enlarged, and dilated in all its cavities. The valves of
the right and left ventricles wore thickened, from congestion of very
minute veins, and were granular to the feel. The substance of the heart
was soft. There were eight ounces of effusion into the pericardium,
resembling that formed in the cavities of the thorax. The liver and the
spleen were large; the former peculiarly yellow and oily. Several very
large veins, containing inky-looking blood, were seen ramifying its
substance. The spleen was very friable. The kidneys were small, and
apparently healthy.
Brain not examined.
This case comes under the third division of the disease. R.'s case is
peculiarly striking, from the length of time (twenty years or more) that
the carbon was concealed within the pulmonary tissue, and also because
he had never been engaged, as far as known, as a stone-miner; so that
this case, along with others, illustrates the fact, that where the
morbid action is the result of lamp smoke, from the combustion of coarse
oil, and not gunpowder smoke, the disease is much slower in its
progress, but ultimately fatal.
* * * * *
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