Excerpts from a Clinical Report and Autopsy by Professor Traube on a Patient with Lung Disease caused by Coal Dust (1860)

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The examination of the black, watery liquid coming from the cut section, undertaken during the autopsy, showed the following:

a) all the myriad shapes of the black and red particles that presented in the sputum while the patient was alive;

b) spherical black bodies of different size, many of them 56 times larger than usual pulmonary epithelia, consisting of a dense aggregate of the described black particles, which could not be shown to have a distinct cell wall;

c) a few well-formed cells of the size and shape of pulmonary epithelia, in which could be seen, in addition to a nucleus of the same shape and size as those contained in pulmonary epithelia, smaller and larger, black, angular corpuscles, at times so long that they reached the size of the largest cell diameter;

d) extensive aggregates of entirely normal epithelia.

Later, when thin segments of the pulmonary parenchyma – which had lost their black content upon brushing – were also examined, the places thereon which had become completely translucent showed no trace of newly-formed connective tissue, as was expected based on the macroscopic behavior.

Epicrisis
I. My firm belief that in this case the black and reddish particles discovered in the pulmonary parenchyma and in the sputum while the patient was alive are, at least for the most part, coal particles is based on the following facts:

a) On the circumstance that these particles are different – in every way, one can confidently say – from the pigment molecules that are found so consistently and in such large number in the lungs of adults, and so frequently in the typical catarrhal and pneumonic sputum.

In both types of sputum the black particles are found almost exclusively in cells, are always very small in size, and never have the irregular, angular shape described above. Identical in makeup are the mostly free granules (i.e., not enclosed in cells) that are found in the sputum in melanotic pulmonary phthisis. It was the behavior of the black particles in the sputum of our patient when I first examined him, which was so different from these, that gave me the idea, as I have already mentioned, that they were coal particles. My view was bolstered when, through repeated examination, I saw more and more of these peculiar shapes I have described. Even a superficial look into the microscope reveals that the black pigment in the lungs itself does not behave differently from that which appears in the sputum in cases of catarrh, pneumonia, and melanotic phthisis.