It is always an alarming thing to see blood in the phlegm one spits, but it is not always dangerous. The blood may come from the nose, or the throat, or the larger bronchial tubes, in all which cases it is unaccompanied with danger; and when it comes from the lungs it is not always dangerous, and should never be allowed to cause panic though it certainly does call for careful medical investigation. A microscopic examination of the blood will determine whether tubercle bacilli are present. When the blood comes from the chest it is usually accompanied with a sensation as if coming from a considerable depth, and there is a taste of blood in the mouth before it comes up.
There is often a burning pain in the chest at the part from which the blood comes. When the blood comes up in great quantities the danger is not so great as is usually supposed. Attacks are sometimes immediately fatal, but in these cases the disease is more often due to aneurysm (disease of blood-vessels) than to disease of the lungs.
General Treatment.-Avoid all possible exertion of the lungs, even talking. Let the patient be perfectly quiet, propped up with pillows to support the head and chest. The room must be kept cool and well aired. No warm drinks or stimulants must be given for several days. Light, easily digestible food must be given, and mucilaginous drinks. All kinds of excitement must be avoided, and sleeping during the day, especially before meals, is an advantage.
Whilst the bleeding lasts, cloths dipped in cold water may be applied to the lower part of the abdomen. Small pieces of ice may be given to suck.
Medicines.-(To be given in an attack every quarter of an hour until improvement sets in.)
Slightest attempt to clear the throat brings up blood; chest seems full with burning sensation; palpitation; agitation; uneasiness; worse lying down; anxious, pale countenance.
After Aconite: constant taste of blood remaining; short cough. Discharge of mucus mixed with blood, nausea and weakness.
Palpitation and agitation increasing after Aconite, disturbing sleep and driving patient out of bed; dry burning heat.
Blood clotted; black and raised easily, accompanied by asthma, shooting pains, and burning contraction of the chest. After injury.