208 DR. R. WILSON ON THE OOAL MINERS 
who is not short-winded. Not having had an opportunity of 
making post mortem examinations in such cases, I cannot say 
what the pathological state of the lung is, but we can easily 
conceive that the irritating nature of the gas which often is 
unavoidably inhaled by them may give rise to spasmodic asthma. 
The sudden changes of the temperature of the air they breathe 
also cause repeated attacks of congestion and bronchitis. The 
small bronchial tubes becoming obstructed, the air vesicles 
behind them collapse, and the surrounding healthy vesicles 
dilate, and so constitute the disease known as emphysema. 
This condition of the lung I believe to be the chief cause of the 
oppressed breathing of the miner. 3861 deaths occur from heart 
disease—this seems a small proportion when we consider that 
the ailment just alluded to brings on heart affection, and also 
that the rheumatic diathesis, which prevails amongst them (not 
the tubercular), is such a great source of organic disease of the 
heart. Contrary to what we might expect, from the violent 
muscular exertions necessary in hewing, and from working fre- 
quently in wet and damp places, and always more or less exposed 
to currents of air, rheumatism and rheumatic fever do not often 
affect the coal hewer. ‘Their freedom from this as well as other 
formidable diseases, is clearly owing to the free perspirations 
while at work, and the daily ablutions with soap and hot water 
at home. ‘The drivers and boys are more exposed to drafts of 
air, and do not perspire so freely; they are, therefore, more 
liable to rheumatic fever, and its frequent consequence, heart 
disease and dropsy. The hard work and constrained position in 
the mine is unsuited for the youth with an enfeebled heart; he 
does not look sufficiently ill to excite compassion or sympathy ; 
but, with the exception of epilepsy, there is no other disease so 
inimical to the poor young pitman. 
Heart disease naturally leads us to the other great source of 
dropsical effusions—disease of the kidneys. There is nothing 
that a pitman complains of oftener than a pain in the back; it 
is sometimes so severe as to unfit him for work. I believe it to 
be lumbago, induced by the great strain on the muscles of that 
part, and in no way connected with the kidneys. I have had 

