THE RESPIEATORY APPARATUS. 323 



work, when it is manifested by extreme dyspnoea, pro- 

 fuse cold perspirations, coldness of the extremities, and 

 extreme rapidity of the pulse, which is scarcely perceptible, 

 also frequent respirations, and, sometimes, a mucous 

 discharge from the nostrils intermingled with blood. The 

 patient occupies the recumbent position, coughs frequently, 

 and has a wild haggard look. 



On post-mortem examination the lungs are found to be 

 enlarged, of a dark red colour, and increased specific 

 gravity. The cavities of the heart are gorged with black 

 blood, which also flows from a section of the lung sub- 

 stance. The bronchial tubes are filled with frothy, often 

 sanguineous mucus. This state is liable to be complicated 

 by rupture of the vessels and extravasation of blood. 

 This is termed Pulmonary Apoplexy, and very seriously 

 increases the complexity of the case, for the blood thus 

 thrown out does not readily become absorbed, and per- 

 manently interferes with the function of a part of the 

 lung varying according to the amount extravasated. 



Subacute pulmonary congestion may be seen in the later 

 stages of blood diseases and anaemic conditions, being one 

 of the metastatic congestions due to deficient nerve force 

 most liable to bring about the death of the patient. Thus, 

 it is not infrequent, and is denoted by the above-men- 

 tioned symptoms manifested less urgently and appearing 

 slowly. In all such cases stimulants are required ; they 

 act in two principal ways, by rousing the weakened heart 

 to increased vigour of contraction and by stimulating the 

 nervous structure of the lungs, whereby the tone of the 

 vessels is resumed and the congestion overcome. Measures 

 must be taken to diffuse the blood which is abnormally 

 heaped up in the lungs by such means as hand-rubbing, 

 hay bandaging or stimulating the extremities. Stimu- 

 lants, too, may be applied to the sides, and the patient 

 clothed and nursed with care. Tonic agents may subse- 

 quently be called for. 



HEMOPTYSIS is Bleeding from the Lungs. The flow of 

 blood may be somewhat profuse, and vary in colour. It 

 is intermingled with mucus, and takes place from the nose 



