The hawking or coughing considerable quantities of blood, or the welling up of the crimson current, as from a fountain, often produces such consternation in there minds of the patient and surrounding friends, as to render them entirely unfit for those prompt and decided steps so essential to safety, and upon which, in fact, the life of the patient may hang. The haemorrhage arising from the nose, mouth, or throat may create unnecessary alarm, and tend to the supposition, that it is really from the lungs. A very slight inquiry into the attending circumstances will be sufficient to detect the difference.

Diagnosis

It will only be necessary for us here to speak of two kinds of haemorrhage.

First, That which depends on congestion to the lungs, and Second, that occasioned by consumption, where ulceration gradually consumes the lung, and in its progress causes the rupture of some of the larger blood vessels. This latter variety not unfrequently dashes to earth delusive hopes, and startles the patient with the alarming fact, that a disease, the very name of which excites a thrill of terror, is weaving its meshes around the fountain of life, and drawing its victim swiftly into the arms of death. It arouses him to the necessity of either doing something, if it be nothing more than a change of air, or be content to die.

The first variety mentioned, or that which depends on congestion of blood to the lungs, may be occasioned by lifting, violent exertion, mechanical injury, or the inhaling of poisonous gases or breathing an air filled with injurious dust, as metal filings, or the dust from lime, tobacco, etc, or it may be constitutional, or produced by rapid changes of temperature, or the abuse of spirituous drinks. It is frequently occasioned by suppression of blood from other organs. Thus we find it caused by the sudden disappearance of the piles, in ladies by the stoppage of the menses, and during pregnancy, by the pressure upward produced by the enlarging womb. Haemorrhage more frequently occurs between the ages of 16 and 40.

The haemorrhage therefore arising from simple congestion of the chest need excite but little alarm.

The most dangerous of this variety of haemorrhage is the apoplectic; when the symptoms of an apoplectic fit are present, the patient looses his consciousness and bloody froth is seen issuing from the mouth.

Treatment.* - In severe cases, perfect repose in a half sitting, half lying position is essential, the patient should not be permitted to speak, and no unnecessary noise or confusion allowed in the room. In the absence of other remedies a teaspoonful of ordinary table-salt may be carefully given, so as not to produce choking, in water every ten minutes, or five or ten drops of Sulphuric-acid, mixed with a tumbler of water, and a tablespoonful given in the same manner, until relieved.

Aconite is an important remedy in the commencement of the difficulty. There is generally a fullness and burning pain in the chest, palpitation of the heart, feeble wiry pulse, pale face, restlessness and anxiety. The blood is discharged in large quantities, at short intervals.

Dose

Two drops, or twelve globules, in a tumbler of water, a tablespoonful may be given every ten or twenty minutes, but if after two or three hours no relief is produced, another remedy should be chosen.

Ipecac

If after the administration of the Aconite a taste of blood should remain in the mouth, or there should be present a slight hacking cough, with expectoration, streaked with blood.

Dose

Same as Aconite.

Arsenicum

Anxiety, palpitation of the heart, seething of blood in the chest, worse about midnight, and spreading a burning heat over the body; after Hyosciamus, in drunkards.

Dose

A powder, dry on the tongue, or one drop or twelve globules in six teaspoonsful of water, a teaspoonful every hour until relieved.

• For general directions as to the administration of remedies, .see page 12.

Arnica - particularly in those cases occasioned by mechanical injuries or violent exertion, and where with but slight exertion, blackish, coagulated blood is discharged, accompanied with stitches, burning, contracting pain in the chest, seething of blood, palpitation of the heart and debility, or where with a cough excited by irritation under the sternum, there is a discharge of bright red, frothy blood, sometimes mixed with lumps of mucus.

Dose

Same as Aconite.

Millefolium is a prominent remedy, particularly where there is a discharge of blood, with but slight, if any cough, fermenting sensation in the chest, with sensation as of warm blood rising in the throat. Often after Aconite, a dose every half hour.

Hamamelis is another prominent remedy in severe haemorrhage.

Dose

Six drops in a glass half full of water and in severe cases a teaspoonful every ten minutes, increasing the intervals to two or three hours, as the haemorrhage and pain subside.

Belladonna

Slight cough produced by tickling in the throat, with aggravation of the haemorrhage, sensation as if the chest were full of blood with shooting pains; worse by movement.

Dose

One drop or six globules, in ten spoonsful of water, a spoonful every half hour.

China

Where the patient is debilitated from the loss of blood, or where there is violent dry and painful cough, with taste of blood in the mouth, shivering with flushes of heat, cloudiness of sight and bewilderment of the head.

Dose

Same as Belladonna.

Hyosciamus

Where it is preceded by a dry cough, particularly at night, or in drunkards after Opium or Nux-vom.

Opium

Particularly in intemperate persons, or where there are expectorations of thick and frothy blood, stifling or shortness of the breath and anguish, trembling of the arms, sleepiness and anxious starts.

Dulcamara

Especially when occasioned by cold.

Rhus

Restlessness, tingling in the chest, discharge of bright, red blood, increased by the least moral emotion.

Pulsatilla

In obstinate cases, with expectoration of black coagulated blood, anxiety and shivering, particularly at night; also when the difficulty is produced by suppression of the catamenia.

Nux-V

Frequently after Ipecac. or Arsenicum and in drunkards after Opium, or where there is tickling in the chest with cough, worse towards morning; also when occasioned by cold, anger, or a sudden suppression of haemorrhoidal discharge.

Curb

v. - Particularly in persons who have taken Mercury, and where there is burning pain in the chest, and where the patient is very susceptible to changes of weather.

Sulphur, Ignatia, Sabina, Stannum, also deserve attention.

Dose

In violent cases same as Aconite, where the discharge is slight every six or twelve hours. In apoplectic cases Aconite should be given immediately, either in alternation with, or followed by Opium, in half an hour's time, if no relief is obtained.

Diet And Regimen

The patient should be kept cool.

Stimulating food and drink should be avoided, and both food and drink given invariably cold. If the feet should become cold, they may be put in warm water.