Cleveland daily leader. [volume] ([Cleveland, Ohio]) 1865-1873, 1866-04-03
Theory of Medicated Inhalation,
DIR. RAMSAY
HemOrrhage from the Lungs and Spit
ting Of Blood.

To the Editor Of tie Leader:
GENTLEMEN: OF all the symptoms, which
indicate the approach of Consumption, there
is ION of such fearful significance, as the
occurrence of Hstreaks Of blood in the mucns
expectorated. If this symptom, does not
tell US that tu5ercles are now actually depos-
tied, it does tell US that the lungs are OBJ
structed and eoaqcsted. and in a very preca-
rious condition. The quantity of blood
brought up from the lungs, may vary from
a few streaks to one or more pInts of blood,
but quantity does not increase the danger to
the patient. The danger lies in the tn6er-
cies, which this symptom tells US are now,
or about to be, deposited in the delicate air
tubes and cells of the lungs, and a few
s;reaks of blood in the sputa, are as strong
a proof of this as the loss of a pint. 1t is
very rare indeed, that life is shortened by
reason of the loss of blood from the lungs,
The alarm, which patients feel, at first
sight Of blood is natural enough, for they
| cannot know, what is the fact. that those
lcho spit blood from time TO time hare a better
| chance Of cure than those tchO DO not lose a
drop.
Splitting of blood is sometimes the first
symptom of Consumption, apparent TO the
patient. More commonly it does not occur
until the disease is fully established. Many
c~onsumptives never spit blood at all Baron
Louis foun hemorrhage in ffty SsUsH cases,
| out OF eiqhty-seUen, Andral in yfrc cases out
of every Sir, and Dr.. Walshe in eighty-Ose
cases out of every hundred, so that we may
set it down as a rule, that the loss OF more
or less blood from the lungs occurs, during
some period of the disease, IN about four
cases out of every fire.
What is the cause ofsplttlng of blood II
is caused by whatever 06StrUctS the free
passage ofthe blood through the pulmonary
cspillaries. Every pulsation of the heart
pumps into the lungs, to be distributed over
the air cells, a certain quantity OF blood.
As the heart never ceases its action, and
could not without stopping the whole ma
| ehinery of life, it will be understood that a
steady stream of blood is flowing from the
heart to the lungs. Now, therefore, if the
lungs are healthy, this blood becomes PUr5-
fed and UitaiiSed, by eXhaling its carbon into
the air-cells, and absorbing Oxygen from the
air we breathe, and is then returned again
to the heart, from whence it goes to nourish
and sustain the system. But let US suppose
the lungs O5stuetel, by the presence of tu-
6erciss, or by what is quite as p~rejU1icial,
viz sticky, tenacious mUcuS in the air tubes.
In the first ease. the vessels through which
the blood must pass are DISTRACTED, and IN
the second the tubes through which the air
passes. The consequence is, that the i'm
pure blood, flows with difficulty, and stag
mates in the delicate vessels, ofthe Obstruet-
ed parts. We physicians say the lung Is
congested by which we mean that the YES
sells are full almost to bursting, ike the YES
sells Of the eye when it Is blOodSh0t. This
condition continues for a longer or shorter
period, and then the vessels relax, and al
low the blood too ooze through their coats,
as fluids do through q filter, and the patient
coughs it up. If the congestion is consider
able, the quantity of blood will be greater;
but no matter how much or how little, it in
dicates that the lungs are in an unhealthy
cnndition-in a word they are obstTucted. 1t
is the business and the duty OF the physl-
clan, to discover the HGture of the obstruc-
ton, By a careful examination of the chest,
and then to prescribe proper means for It's
removal.
1t is a common belief, that the blood
comes from the breaking Of blood-uesSelS and
this idea is entertained by many physicians.
This is no more true, than it would be to
say that bleeding from the nose comes from
the breaking OF a blood-vessel. The blood
merely oozest through the coats Of the RELAXED
uesSsis-in medical phrase we say it is ex-
hailed. Should a vessel of any size actually
break, and such cases do occur, though ex-
tremely rare-the patient necessarily bleeds
TO death, because neither medicine nor sur
gerry, affords US any means by which we
can either apply a StyPtic, t@ortioH, or the
Hqqture. But as this misfortune has never
occurred to me in the treatment of many
thousands of cases Of c~onsumptive disease,
its danger is not worth considering.
From what I nave said it will be under
stood, that splitting Of blood is an alarming
symptom, as showing the progress of a
treacherous and most fatal disease, within
the lungs. Either tuJercles are already de-
posted when it occurs or from this time the
deposition will commence. The stopping Of
the blood gives no assurance Of safety, for
it seldom continues more than a few days
at a time, nor does its r%eoccurrence indicate
any increased danger to the patient. Its
cause lies deeply within the chest, and no
remedy which does not go to the root of the
evil, and remove the distractions within the
lungs, is of the least permanent value
Physicians too often cheer their patients
by the assurance that the blood only comes
from the throat. Let me warn the invalid
against being deceived. The throat seldom
bleeds-never unless it be struck by some
hard substance and wounded ! If blood is
eoughed up, however small the quantity, it
comes from the lungs and delay is danger
Gus. Fortunately, it generally occurs before
the disease is far advanced, and if proper
treatment be employed, it can generally be
arrested. The great error, committed by
physicians is in treating the symptom itself,
while the Cause which produces it is left in
undisturbed possession of the lungs.
It will be asked if hemorrhage never &C.
ours where the lungs are not diseased Yes,
there are three causes which may produce
it: First, injury to the lungs, as from a
violent blow; second, organic disease of the
heart; and third, in females it may occur
every four weeks, instead Of the usual peri
odic exertion. But if a person spits blood,
in whom none of these causes exist, set it
down as q sure sign that the lungs are un-
sound. Bear in mind, too, that palpitation
ofthe heart, and irregularity are far oftener
the effect thar the cause Of splitting of blood.
Patients viii understand the fearful import
of this symptom, when l tell them that
Baron Louis, an eminent French authority
Consumption did not meet loih a single in
out Of tl0elUe hundred cases In ,chich
the loss Of blood lOas not preceded or JoH0tcod
By the dcUeloDmeHt@ tibercieS.
With this I close my observation on the
symptoms of Consumption, and shall in my
next letter, describe the varieties of this
Your obedient servant,
R. DALHoUSTE r. RAMSAY, n. D.
NoTE-Dr. Ramsay, of the firm of Drs.
& Ramsay, of New York and Phil
can be consulted either uersOn-