This study unites disparate historical, poetic, encyclopedic, and filmic sources by their shared project to situate coal on a continuum of forces ranging from life-ending to life-sustaining: on one hand, filth and disease; on the other, energy and employment. When burned sea coal gained popularity as a fuel source in thirteenth-century England, it catalyzed a stream of opposition to its pollution. Chroniclers, poets, encyclopedists, and physicians in medieval and early modern England and France identified its danger to humans as an agent of and metaphor for disease, race, and socio-economic position. These notions of coal as a trans-corporeal link between humanity and the environment in turn illuminate its identification of disease, racial alterity, and socio-economic exploitation in Barbara Kopple’s (1976) documentary, Harlan County, USA. Kopple presents a neomedieval view of coal as the quintessential ecological other, one which makes and unmakes bodies, communities, and environments.