Some aspects of the pathology of pneumokoniosis: part I - the mechanism of the removal of dust particles from the lung

The bodies of mammals possess a very efficient mechanism for ridding themselves of inhaled dust. When the lung is healthy this mechanism works very well, and dust is quickly and completely expelled from the lung either by the respiratory tract or the lymphatics. The mechanism, however, is easily upset, and slight alterations in the condition of the ciliated epithelium or the circulation of lymph are sufficient to interfere with it, therefore the second mechanism comes into play and the dust is fixed and immobilized in some part of the lung. This, however, is not a real cleansing process, since the lung becomes a dust-trap, and may become'pneumokoniotic. The mechanism is protective at first, but later, when the accumulation of dust is considerable, it gives rise to trouble. The lung cannot become, so to speak, a physiological dust-trap, and still retain its normal structure and function; pneumokoniosis begins, which is essentially a disease due to the mechanical presence of large amounts of inert foreign material.