BRONCHOPULMONARY HEMORRHAGE 45 



Treatment. — ^Bleeding is indicated when the dyspnea is 

 very great. In large animals remove 4 to 6 quarts of blood 

 from the jugular. Its affect is often life-saving. The 

 application of oil of mustard to the chest is helpful. While 

 the heart is weak give excitants (alcohol, ether, caffein). 

 Sulphate of atropin (gr. i to | subcutaneously) is good in 

 cases where edema predominates (foamy nasal discharge). 

 Digitalis and strychnin are also recommended. In milder 

 cases an aloes ball affords relief. Nitroglycerin (gr. | to j) 

 is sometimes used. 



Bronchopulmonary Hemorrhage (Bronchorrhagia, Pneu- 

 morrhagia, Bleeding from the Lungs, Hemoptysis).— DeQaitioii. 

 — Bleeding from the lower air passages and lung tissue. 



Etiology. — Bleeding from the bronchial mucous mem- 

 brane may be due. to overexertion, as fast driving, racing. 

 It is seen in valvular heart disease, congestion of the lungs, 

 aneurysms (aorta, pulmonary artery), lung infarctions, 

 thrombosis, embolism. In infectious diseases it is at times 

 a symptom (fibrinous pneumonia, purpura hemorrhagica, 

 anthrax, glanders, tuberculosis) . Where caverns of the lung 

 remain after pneumonia, hemorrhage occurs. Frequently 

 no cause can be found on postmortem to explain the hemor- 

 rhage. 



Symptoms. — ^Bleeding from the nose is the principal 

 symptom. If the blood come from the larger bronchi, it 

 will flow from the nostrils in drops or in a thin stream and 

 is usually not frothy. From the finer bronchi and lung the 

 blood is frothy and of light red color. The patient is dyspneic 

 and coughs. In severe cases the patient is restless, the 

 mucous membranes pale, the body covered with sweat and 

 the legs and ears cold. The pulse becomes rapid, very weak 

 and thready. In profuse hemorrhage the bronchi and trachea 

 may fill with blood leading to suffocation. On auscultation 

 rales are heard. Percussion normal. 



Diagnosis. — When the discharge is bilateral, light colored, 

 foamy and attended by cough, the diagnosis is not difficult. 

 When the blood comes from the nostrils, pharynx, mouth or 

 gullet it is usually dark colored, not frothy or contains 

 only a few coarse air bubbles. Blood vomited through the 



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