First extract.—"The cases of phthisis pulmonalis which came under my notice during my practice in Cornwall, were very numerous. I have, indeed, witnessed this malady in, I believe, almost every variety both of shade and stage, and in every age from 15 to 60.
"With respect to that chronic form of the disease, or what in Cornwall has been called the miners consumption, I should think that full three fourths of those who continued to work under ground to the age of 50, are, more or less, affected with it, and a great number die of it between the ages of 40 and 55. It seldom proves fatal in a shorter period than two or three years, in some instances going on to five or even to eight or ten years. During this time, there will be numerous aggravations of the disease, particularly in the winter season, and especially marked by increase of dyspnœa, always aggravated by bodily exertion, and more or less expectoration and some degree of emaciation These are, nevertheless, unaccompanied by the usual hectic symptoms, the pulse, for the most part, not exceeding 70, and being sometimes even as low as 50. The hectic symptoms, however, invariably came on for some months before death, the pulse at last reaching, and more frequently exceeding, 120, and the emaciation becoming extreme.
"This form of phthisis, however, I have witnessed in persons who never worked under ground, but much more rarely than in miners. It is not wholly confined to persons advanced in life, though I conceive the more rapid character of the true tubercular consumption is by far more frequently observed in younger patients.
