Is it from the lungs, or from the throat, mouth, or nostrils?

Not unfrequently, bleeding from the nose goes backwards, into the throat, and the blood, then hawked up, is naturally imagined to come from the lungs, sometimes causing great alarm. Inquiry and examination will make it clear whether this, or bleeding from the mouth, is the case.

Ulcerated throats sometimes bleed. The ulcer can then be seen, in a good light, if the tongue is pressed down with the handle of a tablespoon. This sort of bleeding, however, is not at all common.

When vomiting occurs before blood appears, we ascribe it to the stomach. The blood is then, usually, rather dark and thick; not fresh looking.

If real bleeaing from the lungs takes place, the blood is coughed up (perhaps quite softly and lightly); it is, as a rule, bright red. Only a little may come; sometimes merely streaking the expectoration; or it may be copious; mouthfuls all at once. In this last case, it is attended by danger of exhaustion from the loss of blood.

No unprofessional person should think of taking charge of a serious hemorrhage without the aid of a physician, if one can be had. While waiting for one, however, what ought to be done ?

Put the patient upon a bed, with the head and shoulders comfortably raised with pillows. He must keep very still and not speak. Let a piece of ice be taken into his mouth every few minutes, and swallowed slowly. Then fasten around each arm, above the elbow, a shawl-strap, if such be at hand, or a long handkerchief, quite tightly; leaving each on, however, only a few minutes at a time. If the bleeding does not stop, let them be tightened again and again, several times. Should this not succeed, and the doctor has not yet arrived, similar straps or bandages may be applied in the same manner to the lower limbs, just below the knees.

If blood comes from the stomach, it may be from ulceration, or cancer; or it may be hysterical (that is, connected with general nervous disorder), or, in exceptional cases, may take the place of menstruation which is suppressed. (Bursting of an aneruism of the aorta is a possible source of hemorrhage, either from the stomach or from the lungs but the existence of such an aneurism will mostly have been before discovered by an attending physician).

To moderate or check large bleeding from the stomach, as shown by free vomiting of blood, ice is the safest and most hopeful of remedies. Keeping quiet, and taking the least possible food in the liquid state, are important Boiled milk with lime-water will be the most suitable nourishment; or arrow-root, tapioca, etc. In the absence of medical advice, no medicine had better be ventured upon; unless it be swallowing very small amounts of solution of alum, or, once in two or three hours, a single drop of creosote, dissolved in two tablespoonfuls of water.