mining, and would not be convinced of its injurious effects.

_July 1835._ There was considerable increase of the palpitation when he
attempted the recumbent position, or moved hurriedly. The remedies
ultimately seemed to produce little effect. His general exhaustion
advanced rapidly, and obliged him to relinquish all mining occupation.
At the end of the summer of 1836, when I saw him more regularly, and was
enabled to watch his symptoms with more attention, these having
materially changed for the worse, percussion elicited dulness over the
chest, with the exception of the upper part of both lungs, where the
mucous rale was heard louder than usual. The heart's action was strong
and irregular, particularly so for some time after a fit of coughing,
when he suffered excessively from headach, succeeded by a tendency to
drowsiness. The pulse was slow and languid, not exceeding 50 in the
minute. His countenance had assumed a greyish inanimate aspect, his eyes
became sunk, his robust frame bent and so emaciated from this peculiar
disease, that though his age did not exceed 38 years, a stranger looking
at him, supposed him to have attained the age of 70. No treatment seemed
to have any effect in allaying the cough, nor was he permitted to lie
down. From his feeling of dyspnoea and thoracic oppression, his nights
were almost sleepless, his extremities oedematous, usually cold and
bloodless.

During the greater part of the time he was confined to the house, the
bowels were constipated, requiring daily purgatives. The urinary
secretion was small in quantity and high coloured, but in neither
discharge was there any thing very unnatural. In this almost inanimate
condition he lingered on, when about six months before his death, during
a paroxysm of cough, he expectorated a mouthful of thick black matter,
and continued so to do periodically, at intervals of about three weeks,
seeming to experience relief after voiding the carbonaceous sputum.

There was little change in the symptoms of this man till death. He took
little or no food, from his appetite being almost entirely gone, and
from gastric irritation being constantly present. His cough and
dyspnoea continued severe, with drowsy headachs and difficulty in
keeping the body warm. The arterial action was exceedingly low. The
pulse was 40 in the minute, and difficult to discern. The strongest
stimulant produced no increase of action, the sitting position was the
only one in which he