HjEMORRHAGIES. 245 



ulcer of the lungs : but I will presume to say, that, in general, 

 this is a mistake ; for there have been many instances of hae- 

 moptysis occasioned by external violence, without being followed 

 by any ulcer of the lungs ; and there have also been many in- 

 stances of haemoptysis from an internal cause without any con- 

 sequent ulceration. And this too has been the case, not only 

 when the haemoptysis happened to young persons, and recurred 

 for several times, but when it has often recurred during the 

 course of a long life. It is indeed easy to conceive., that a rup- 

 ture of the vessels of the lungs, like that of the vessels of the 

 nose, may be often healed, as the surgeons speak, by the first 

 intention. It is probable, therefore, that it is an haemoptysis in 

 particular circumstances only, which is necessarily followed by 

 an ulcer ; but what these circumstances are it is difficult to 

 determine. It is possible, that merely the degree of rupture, 

 or frequently repeated rupture preventing the wound from 

 healing by the first intention, may occasion an ulcer ; or it is 

 possible that red blood effused, and not brought up entirely 

 by coughing, may, by stagnating in the bronchiae, become 

 acrid, and erode the parts. These, however, are but supposi- 

 tions, not supported by any clear evidence. And, if we con- 

 sider, that those cases of haemoptysis which follow the predis- 

 position (DCCCXXXIL DCCCXXXV.), are those espe- 

 cially which end in phthisis, we shall be led to suspect, that 

 there are some other circumstances which concur here to deter- 

 mine the consequence of haemoptysis, as I shall hereafter en- 

 deavour to show. 



DCCCLXV. Any supposition, however, which we can 

 make with respect to the innocence of an haemoptysis, must not 

 supersede the measures proposed above for its cure ; both be- 

 cause we cannot certainly foresee what may be the consequences 

 of such an accident, and because the measures above suggested 

 are safe ; for, upon every supposition, it is a diathesis phlogis- 

 tica that may urge on every bad consequence to be appre- 

 hended. 



DCCCLXVI. The second cause of an ulceration of the 

 lungs to be considered, is a suppuration formed in consequence 

 of pneumonia. 



DCCCLXVII. From the symptoms already mentioned in 



