b) A second fact is the empirical match between the black and red particles found in the sputum and the dust of the material which the patient was compelled to handle for twelve years. For immediately after the first examination of the sputum, I sent for charcoal briquettes from the place where the patient had worked. I examined the finest particles that were released by light shaking and knocking of the obtained fragments, which, logically, were most likely to resemble those that were inhaled by the patient because they were suspended in the atmosphere on account of their small size. As the attached table (which, like the other two, Herr Dr. Munk was kind enough to prepare) shows, the experiment provided striking confirmation of my suspicion. The match between these figures and those represented by the particles of the sputum could not be any greater. Unfortunately I paid too little attention to the red particles, which is why they are not represented in the chart.
c) A third fact is the match between individual shapes in the sputum with drawings that we have of the wood cells of pinus sylvestris. The necessary information has already been included in the case history. Here it should be mentioned that the mentioned fragments with the round holes or segments of such are undoubtedly charred ray cells.
The explanation for the simultaneous occurrence of black and reddish particles in both the sputum and the pulmonary parenchyma does not strike me as difficult. The color of the latter results from the fact that their carbonization is not as advanced as that of the black particles. In fact, we can produce the same color differences in every piece of wood and paper, depending on how much or little we expose it to the effect of the flame.
[ . . . ]
III. Moreover, it seems to me that no small importance attaches to the fact, repeatedly and precisely established by me post mortem in various pulmonary epithelia, that these same epithelia contained coal particles. This fact proves that it is entirely possible for foreign bodies to penetrate into cells of the organism without causing their destruction or even perceptible changes in them. The question of how this introsusception came about does not appear to me difficult to answer. The particles driven by the inhaled air stream arrive in the alveoli with a certain speed, which is why they are easily able to penetrate the cell walls they encounter, especially since they are sharp and pointed bodies.
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