PULMONARY EDEMA 43 



Sulphate of atropin (gr. | 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 tfa Lungs, Hemoptysis). — Definition. 

 — 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 ip explain the hemor- 

 rhage. 



Symptoms. — Bleeding from the nose is the principal 

 symptom. If the blood comes 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. On auscultation rales are heard. Percussion 

 normal. 



Treatment. — The patient should be kept as quiet as 

 possible. Ice packs (or cold water) may be applied to sides, 

 vulva or scrotum (reflex affect). Internal medication does 

 little good. Ergot in the form of fluidextract is recom- 

 mended by most practitioners; others condemn it. Acetate 

 of lead (5j) given three times daily is employed in obstinate 

 cases. Sulphuric acid (dilute 5vj) is sometimes beneficial. 

 Theoretically aconite (Fleming's tincture nix) is good as it 

 lowers blood-pressure. Lung hemorrhages which are due 

 merely to congestion of the bronchial mucous membrane 

 or lung usually stop spontaneously when the blood-pressure 

 becomes low. On the other hand, those hemorrhages due to 

 a ruptured vessel in the lung (aneurysm) are generally 

 copious enough to produce death. 



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