A Case Wherein Part of the Lungs Were Coughed up. Presented to the Royal Society by William Watson, F. R. S.

XIII. A Case wherein Part of the Lungs were coughed up. Presented to the Royal Society by William Watson, F. R. S. Thomas Halfey, aged about 70, of a short Make, and pretty fat, being in a tolerably good State of Health, (unless, as for some Years past, troubled with frequent coughing upon Motion) was seized Sept. 23. 1740. with a violent Fit of Coughing, in which he fell down, as the By-standers thought, dead, and discharged near a Quart of Blood at his Mouth, in a very large Stream, mixed with many Portions of a seemingly grumous Matter. His coughing Fit continued near Three Minutes. He revived upon bleeding at the Arm, and, being put to-bed, recovered his Senses, and (as he said) was perfectly easy, and free from Pain, except upon Coughing, which as often as he did, he spit Blood visibly arterial from its florid Colour. About Four Hours after the First Fit, he was taken with a Second, attended with the same Symptoms as the First; and expired in it. Upon examining the Blood, which he brought up at his Death, I found, in Pieces of different Sizes, near Three Ounces of the Substance of the Lungs, not ulcerated, or any ways distempered; and I have Reason to believe there was near the same Quantity of the Lungs thrown up during the First Fit of Coughing. The Pieces were easily distinguishable from grumous Blood, by their connecting Membrane, the Acini in the internal Part, and their specific Gravity. Upon examining the Contents of the Thorax after Death, the Right Lobes of the Lungs were sound, of a good Colour, and no-ways injured: In the Left Cavity of the Thorax, there was a large Quantity of extravasated Blood; the inferior Left Lobe adhered strongly both to the Pleura and Mediastinum, and was somewhat decayed; but of the superior Left Lobe, the upper Part next the Trachea adhered to the Pleura for about Two Inches; and the Remainder, where there had been no Adhesion, (as I could perceive from the smooth Surface of the Pleura) was torn away by Pieces, and discharged in Coughing. As the greatest Part of the Left Side of the Lungs was tied down to the circumjacent Membranes, the Person being old, and the whole Force of the Parietes of the Abdomen, Diaphragm, &c. in the Action of coughing, was unequally exerted upon that Part that did not adhere, and which, by the Violence of the Pressure, was torn off from the rest, and discharged, as I just now mentioned; it is worthy Observation, how small the Degree of Sensibility is in the Lungs; that a Person should lose so much of their Substance, as in this Instance, upon the First Fit; and yet, upon Recovery of his Senses, to complain of little or no Pain from such Dilaceration, when even the Bite of an Insect upon the Surface of the Body is attended with so much. The Adhesion of this Man's Lungs explained likewise the Cause of his frequent Coughing for some Years before his Death.