HAEMOPTYSIS. 99 



maladies, and of the last stages of malignant or low fevers. The 

 quantity of blood discharged maj^ vary from a few drops to many 

 pounds ; and in the more obstinate passive states the patient may 

 be reduced to the utmost danger, or may be carried off in a few 

 hours or days, according to the continuance or violence of the dis- 

 charge. 



Treatment. — If the patient be robust or plethoric ; if he have ex- 

 perienced attacks of determination of blood to the head ; the dis- 

 charge should not be arrested until the vascular system is relieved, 

 and when this is accomplished the epistaxis will cease of itself If 

 it should seem to cease prematurely, and particularly if the above 

 symptoms still continue, depletions, purgatives, and an antiphlogistic 

 regimen ought to be prescribed. 



When it is requisite to check the hemorrhage, the patient ought 

 to be placed in a cool, airy apartment, with the head elevated, or 

 held upright, and the feet plunged in warm water containing mus- 

 tard. The neck should be bared, and cold fluids aspersed over it 

 and the face, or ice applied upon the nape of the neck or upon the 

 forehead ; and an active cathartic exhibited ; the sulphate of mag- 

 nesia with sulphuric acid is the best. Lemonade and cooling drinks 

 may also be given. When the epistaxis has become habitual, or 

 periodic, and especially if it be vicarious of menstruation, it may 

 be anticipated by cupping on the nape of the neck. 



In the jjassive or atonic states of the disease, astringents should 

 be injected into the nostrils, and astringents and tonics given inter- 

 nally. A solution of acetate of lead, or of sulphate of zinc, or of 

 sulphate of iron or copper, or of the sulphate of alumina, may be 

 injected into*the nostrils ; oi lint, moist with either of these solutions, 

 introduced. The superacetate of lead, with acetic acid, and small 

 doses of opium, may be exhibited with advantage. If the bleeding 

 will not stop, the anterior and posterior apertures of the nostrils 

 should be plugged. 



HEMOPTYSIS AND PULMONARY APOPLEXY. 



(^Hemorrhage from the Respiratory Organs.) 



Haemoptysis is one of the most frequent varieties of hemorrhage, 

 owing to — 1st, the very extensive bronchial and vesicular surface 

 to which the blood is circulated for the purpose of undergoing the 

 requisite changes during respiration ; 2d, to the delicate conforma- 

 tion of the capillaries of the mucous membrane of this part ; 3d, to 

 the liability of the lungs to congestions, from impaired nervous 

 power, from obstructions of the pulmonary veins and of the circu- 

 lation through the left side of the heart, and from tubercular or 

 other lesions of the substance of the lungs. 



We may admit three principal sources for the blood which is ex- 



