Symptoms. Diagnosis. 89 



Symptoms. Hemorrhage of the kings does not alv/ays 

 become manifest because small amounts of blood may remam 

 in the air passages and may be absorbed rapidly or they may 

 coagulate and subsequently disintegrate. An insignificant 

 hemorrhage manifests itself sometimes in such a manner that 

 an existing nasal secretion or bronchial sputum contains small 

 bloody dots or streaks, or that it looks saffron-yellow or rust- 

 brown in consequence of an intimate admixture of blood. (A 

 saffron-yellow color is seen particularly in pneumonia, a rust- 

 brown color in valvular disease of the heart.) 



Severe pulmonary hemorrhages lead sometimes to a fright- 

 ful flow of blood out of the nostrils and mouth, and intense 

 dyspnea is associated with such an occurrence. The flow is 

 usually bright red and foamy and small air bubbles may even 

 be seen in a coagulum which may have formed. The respira- 

 tion is much accelerated and convulsively difficult ; the animal 

 betrays great anxiety, trembles, perspires, staggers and finally 

 falls down if the hemorrhage continues. The mucosa, at first 

 cyanotic, becomes gradually paler ; the pulse becomes accelerated 

 and fifiform. Rales are 'occasionally heard over the lungs; 

 also over the trachea ; sometimes crepitant sounds are audible. 



The significance of pulmonary hemorrhage depends pri- 

 marily upon the amount of blood lost. Animals may look 

 healthy after small amounts of blood are lost, larger animals 

 even after the loss of three or four quarts ; although they may 

 show a transitory weakness. A considerable loss of blood leads 

 more or less to the signs of grave anemia which disappears only 

 after a long time or may lead to cachexia. Very excessive 

 hemorrhage may, of course, terminate fatally in a very short 

 time, within fifteen to thirty minutes. 



Diagnosis. Hemorrhage of the lungs may be recognized 

 from the bright red and foamy character of the blood voided. 

 The source of the hemorrhage however is recognized only with 

 difficulty. It may occur that blood coming from the posterior 

 parts of the nose, as well as blood coming from the mouth, 

 pharynx or esophagus flows backward to be then expelled with 

 attacks of coughing. Under these circumstances the blood does 

 not contain numerous air bubbles and the examination of the 

 parts named and of the thorax will usually afford information 

 about the source of the blood. In hematemesis the blood is 

 expelled with vomitory movements, it appears dark in color, 

 and is often mixed with coagula ; it reacts acid and frequently 

 contains particles of food. One must, however, not forget that 

 the act of vomiting is brought about in smaller animals by 

 coughing, that vomited blood may subsequently get into the 

 air passages, that blood from the lungs likewise becomes dark 

 later on and that a large amount of blood will remain alkaline 

 even in the stomach. Hence, in making a diagnosis, it is neces- 



