LUNGS. BLEEDING FROM.–It is not by any means always that spitting of blood means bleeding from the lungs. The blood may come from the back of the nose, from the throat, or from the mouth itself. Streaks of blood in the expectoration in cases of bronchitis or inflammation of the lungs do not signify much; it is a common symptom of these complaints. Bleeding from the lungs, when it is of any amount, is accompanied by chest symptoms. It appears to the patient to come from a considerable depth; it is warm, generally tastes sweet, the taste being experienced before the blood comes up. At times there is a painful, burning sensation in the chest.
Bleeding from the lungs,though always alarming, is not so immediately dangerous as is commonly supposed. Even when large quantities come up it is not usually fatal at the time. (In the cases where the bleeding is immediately fatal the source of it is usually aneurysm,or disease of an artery and not the lungs.)
Diagnosis.–Bleeding from the lungs (blood-spitting, Haemoptysis) is distinguished from bleeding from the stomach (vomiting blood, Haematemesis) by the presence of cough and chest symptoms, notably rattling sounds heard on listening to the chest, and by the blood being either pure or mixed with frothy phlegm. In blood-vomiting the blood is not brought up by a cough, but by an act of vomiting, and it is generally blacker, and altered by the action of the digestive fluids. In bleeding from the nose, blood may run down the throat in sleep, and may be brought up by vomiting, but in this case there is generally blood to be found on the handkerchief on blowing the nose, or a history of previous nose-bleeding.
General Treatment.–Bleeding from the lungs is almost always one of the accidents of consumption. But it is an accident which requires special treatment. It sometimes results from a blow on the chest. Though not so dangerous as it is usually considered, it is always so serious as to demand prompt treatment. As soon as the first symptoms appear, absolute rest must be enjoined, the patient lying with the head and chest well supported with pillows. The room must be kept cold and well aired, and only cold food of the lightest description and cold drinks taken. When the bleeding comes on the patient must be given ice to swallow; clots dipped in ice-water should be applied to the lower abdomen.
–Full sensation in the chest, agitation, uneasiness, anxious, pale countenance; when the slightest attempt to clear the throat brings up blood.
–Taste of blood, with short cough; mucus mixed with blood; nausea and weakness.
–If caused by violence; blood clotted, and raised easily; when the blood is bright red, frothy, mixed with small clots and mucus, raised with slight cough; coughing produces shooting pains in the head, and all the ribs feel as if bruised.
–Frequent bleedings of small amount.
–Dark, clotted blood.