An attack of hxmoptysis is usually preceded by certain premonitory symptoms, such as chilliness, headache, lassitude, and a quick and vibrating pulse. The patient also experiences a sensation of weight and constriction at the chest, with a feeling of beat and itching in it. The ,expectoration of blood is attended with cough. Sometimes the quantity brought up is very considerable, and is expelled with violence ; at other times the sputa are only streaked with it. The expectorated blood is generally of a vermilion colour, and when in:small quantities, it is frothy and mixed with air. When the blood comes from the stomach, it is brought up by vomiting and without cough, without the frothy appearance, and is of a dark grumous character.
Pulmonary Apoplexy.—When it happens that the blood, instead of being exhaled into the air-tubes, is effused into the parenchymatous structure of the lungs, the name of pulmonary apoplexy is given to it. One or two lobules, or a small portion of the lungs only, may be affected in this manner, the structure of the part not being broken down by it. When this is the case, hremoptysis may not take place. Such effusions are found after death in the form of circumscribed indurated masses of a dark brown colour nearly approaching to black, and surrounded by the lung in a perfectly healthy state. Life not being immediately destroyed in such cases, time is given for the absorption of the most fluid parts of the blood, which will account for the indurated character of these deposits. When the effusion is more extensive, large portions of the substance of the lung may be torn and broken down, and hmmoptysis to a very considerable and generally immediately fatal extent takes place.
One of the most common causes of pulmonary apoplexy is disease of the heart, by which the circulation through the lungs is impeded and oppressed with blood. The eauses mentioned as conducing to
hmmoptysis are also common to this affection, and the symptoms are very similar. The plan of treatment in these affections is founded on the same general principles as are applicable in any case of internal haemorrhage. [H/EMORRHAOE.] Phthisis Pulmonalis is by far the most frequent and most fatal of all diseases of the chest. [Pwrstssrs PULx0NAu.Is.l Malignant Diseases of Lungs.—The lungs are also subject to diseases of h specifically malignant nature, such as medullary sarcoma and melanosis; but these rarely occur as a primary affection. The medul lary and melanoid matter is deposited in these organs as a secondary affection, in conjunctionssvith its existence in other parts, and frequently in all or the majority of the organs of the body.
Black or Carbonaceous Matter in the Lungs.—A peculiar discoloration in the lungs of persons who have died after working for a long period of time in coal-mines, or in mines where gunpowder is used in large quantities for blasting masses of rock, has been observed. The lung is found of a coal-black colour throughout, thoUgh still perfectly natural in all its other characters. It also exists in connection with disease of the lung, and the expectoration of persons so affected partakes of the same colour. The cause of it seems to be doubtful ; but most probably it arises from the inhalation and absorption of the carbon aceous matter existing in the atmosphere of such mines.
Bony and cartilaginous tumours have been found in the lungs, and the membrane surrounding the lungs (the pleura) is sometimes met with converted into bone ; sometimes it is studded with tubercles similar to those found in the lungs of Phthisis.
For an account of inflammation of the pleura see PLEURISY. LUPININ, a bitter non-azotised matter of unknown composition contained in lupin seed.