Haemorrhage of the lungs, or rather from the bronchial mucous membrane, when occurring suddenly and in considerable amount, greatly reduces the strength, and naturally alarms the patient and excites the nervous system. Absolute quiet must be immediately secured by rest in bed without a pillow, so that the body may lie flat, and the head and arms should on no account be raised. The room should be kept quiet and the patient must not be allowed to speak or to feed himself. A reliable and quiet nurse should be secured for him, and he should be fed upon a nutritious diet, which requires no effort in eating. Small quantities only of fluid should be given at one time through a glass tube or by a teaspoon, so that the head need not be raised. If nausea occurs, every effort must be made to control it, for the violent muscular action and the temporary circulatory and respiratory disturbances occasioned by the act of vomiting might excite further haemorrhage. It is desirable to reduce the blood pressure in the lungs as much as possible in order to allow coagulation of the blood to occur over the oozing surface of the bronchial mucous membrane, and therefore large quantities of fluid should not be given at first. The patient is usually thirsty from the loss of blood and temporary drying of secretions.

The thirst may be relieved by crushed ice and small quantities of cold acidulated drinks, such as very dilute phosphoric acid or sour lemonade, and if the stomach is in normal condition, plain milk may be given or else pancreatinised milk and strong beef broth in quantities not exceeding two or three ounces in as many hours.

It is customary to administer all fluids cold, but the advantage of this is overrated. Warm fluids have a somewhat more stimulating effect upon the heart, and are more rapidly absorbed, but the idea sometimes advanced that the cold of iced fluids taken into the stomach is ever sufficient to constrict the bleeding bronchial vessels, even by supposed reflex action, does not appear rational. For a full discussion of this question the reader is referred to experiments reported upon p. 338.

If coincident gastric disorder is present with bronchial haemorrhage, to forestall vomiting it may be better to resort to nutrient enemata.

In cases where exceptionally large quantities of blood have been lost, the blood pressure may be greatly reduced and the danger of death from heart failure may appear imminent. It then becomes necessary to give a larger quantity of fluid, and the rules in regard to the dietetic treatment of severe and sudden haemorrhage taking place anywhere from the body must be observed. Salt and water, a teaspoonful to the pint, may be injected into the rectum, or even beneath the skin. Most cases, however, are more mild, and after a few hours of rest and quiet, furthered, perhaps, by the hypodermic injection of morphine, the patient will be able to retain a little simple semisolid food, such as milk toast, a beaten egg, junket, etc.

If there is no return of the haemorrhage in a day or two, the diet should be increased and anaemia consequent upon the bleeding must be treated by an abundant meat diet. As a rule, alcoholic stimulants should be avoided, on account of the relation of blood pressure to the bleeding, or they should be given in moderation, unless the danger of heart failure is imminent.