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A coughing up of blood.

Hemorrhage from the mucous membrane of the lungs; characterized by the expectoration of more or less florid and frothy blood. It is generally preceded by cough; dyspnoea; sense of heat in the chest, &c. It is important to discriminate between haemoptysis, produced by some accidental cause acting irregularly or periodically on the lungs; and that which is, as it were, constitutional, and dependent on some organic affection of the lungs, or some faulty conformation of the chest. These two varieties differ as much in their prognosis and method of treatment as in their causes. Constitutional haemoptysis is a serious disease, almost always announcing phthisis pulmonalis. The accidental variety is chiefly dangerous by frequent recurrence, or too great loss of blood. The general causes of haemoptysis are the same as those of other kinds of hemorrhage. It has, besides, particular causes; such as too great exercise of the lungs; loud speaking; playing on wind instruments, breathing acrid vapours, &c. It usually occurs between puberty and the age of 35. A sudden and terrific kind of haemoptysis is sometimes met with; consisting in a great afflux of blood to the lungs. Infiltration of blood into the air-cells may occur without any haemoptysis. Physical signs. Percussion may not always aid us in haemoptysis, but generally a circumscribed dullness will be perceived. The inspiratory murmur, on auscultation, is feeble or absent, locally; and is replaced by bronchial respiration and bronchophony. A fine liquid crepitus is detected around the affected part; and in the larger tubes, near the spine, a liquid bubbling rhonchus is usually heard. The value of these signs is determined by the nature of the expectoration. The treatment of haemoptysis must be like that of internal hemorrhage in general.