HUEMORRIIAGIES. 235 



coming to their full growth, or soon after it ; and this for the 

 reasons fully set forth above. 



DCCCXXXVI. From all that has been said from 

 DCCCXXXI. to DCCCXXXV., the predisponent cause of 

 haemoptysis will be sufficiently understood, and the disease may 

 happen from the mere circumstance of the predisponent cause 

 arising to a considerable degree. In the predisposed, however, 

 it is often brought on by the concurrence of various occasional 

 and exciting causes. One of these, and perhaps a frequent one, 

 is external heat ; which, even when in no great degree, will 

 bring on the disease in spring, and the beginning of summer, 

 while the heat rarefies the blood more than it relaxes the solids, 

 which had been before contracted by the cold of winter. An- 

 other exciting cause is a sudden diminution of the weight of the 

 atmosphere, especially when concurring with any effort in bodily 

 exercise. This effort too, alone, may often, in the predisposed, 

 be the exciting cause ; and, more particularly, any violent exer- 

 cise of respiration. In short, in the predisposed, any degree of 

 external violence also may bring on the disease. 



DCCCXXXVII. Occasioned by one or other of these causes 

 (DCCCXXXVI.), the disease comes on with a sense of weight 

 and anxiety in the chest, some uneasiness in breathing, some 

 pain of the breast or other parts of the thorax, and some sense 

 of heat under the sternum ; and very often, before the disease 

 appears, a saltish taste is perceived in the mouth. 



DCCCXXXVIII. Immediately before the appearance of 

 blood, a degree of irritation is felt at the top of the larynx. To 

 relieve this, a hawking is made, which brings up a little blood, 

 of a florid colour, and somewhat frothy. The irritation returns ; 

 and, in the same manner, more blood of a like kind is brought 

 up, with some noise in the windpipe, as of air passing through 

 a fluid. 



DCCCXXXIX. This is commonly the manner in which the 

 haemoptysis begins ; but sometimes at the very first the blood 

 comes up by coughing, or at least somewhat of coughing ac- 

 companies the hawking just now mentioned. 



DCCCXL. The blood issuing is sometimes at first in very 

 small quantity, and soon disappears altogether ; but, in other 

 cases, especially when it repeatedly occurs, it is in greater quan- 



