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"Ohh, that can't be good."

"Thou lov'st me not; for, brother, if thou didst,
Thy tears would wash this cold congealed blood
That glues my lips and will not let me speak.
Come quickly, Montague, or I am dead."
Warwick, Henry VI Part 3, Act V, Scene 2
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A character is either dying or badly injured when they start bleeding from the mouth.

In Real Life, coughing blood can indeed indicate life-threatening damage. One of the scientific names for this symptom is "Hemoptysis." It can result from organ and tissue damage from disease or trauma; punctures in the respiratory and gastro-intestinal tracts; and massive trauma to the body as a whole. This is an especially big warning if the lungs have been punctured, as the victim can drown in their own blood if not treated. As a death trope it's caused by any fatal injury, and is less a symptom than a signal to the audience that this dude's a goner. Much like the chest-clutching and doubling over in days of old, Blood From the Mouth is a sign of death that won't horrify us with the specifics, keeping our focus on the story itself.

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However, not all Real Life bloody mouths are immediately dangerous. Damage to the gums in a fistfight, biting your tongue, or a particularly copious nosebleed can just as easily replicate the appearance. When it's not a death trope, blood around the mouth simply indicates the character has just taken a worse beating than usual. Our hero gets smacked around some and ends up with a bloody lip - not a big deal unless there's staggering involved. They might even spit out the blood defiantly, along with a tooth, just to showcase their resolve. Was that hit fatal? If the character wipes the blood away and it does not return, it's cosmetic Blood From the Mouth. Expect to hear My Name Is Inigo Montoya any second now.

A Sub-Trope of He's Dead, Jim. See also First Blood, Soap Opera Disease and Incurable Cough of Death. Saying I'm Cold... So Cold... is another very bad sign. Occasionally overlaps with Deadly Nosebleed.

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Not generally related to the Psychic Nosebleed; combine the two and get Blood from Every Orifice. If it's the only sign the character gives that they're injured, it's a Mortal Wound Reveal. Blood from the mouth is also an increasingly popular way to show damage taken from a Deadly Upgrade, or over reliance on a Super Mode.

A stream of blood trickling from the mouth is also shorthand for "I am a vampire", because vampires drink blood and are commonly depicted as having poor table manners.

As this is a Death Trope, all spoilers will be unmarked in the examples below. Beware!


Example subpages:

Other examples:

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    Comic Books 
  • In All Fall Down, Siphon suffers this before the end.
  • Jhonen Vasquez once made fun of this trope in his deliberately horrible comic, The Bad Art Collection. A character is wounded and blood comes from the mouth. Paraphrased: "Oh, no! I did a blood burp! That means I'm dying!"
  • Beasts of Burden: In "Grave Happenings", Karl casts a spell on Miranda that makes her vomit blood.
  • Daredevil uses this trope frequently during fights, one notable instance was in the Born Again storyline where Kingpin punches Matt in the face so hard that Matt spits a large spray of blood.
  • The Beauty: The first person to die in the comic coughs into her hand, and the next panel reveals that she coughed up blood. She also has some on the side of her mouth, as well as some coming out of her nose, right before she spontaneously combusts from the inside. This is what happens right before someone infected with The Beauty is about to die in that manner.
    • During the shootout at the meeting with Jocelyn Grace, one of the people shot has blood that seems to be coming from his mouth.
  • Green Lantern: Evoked with the Red Lanterns. Becoming one involves a person's blood being replaced by a burning red acid which they can use as a weapon by puking it at opponents.
  • Happens to Abe Sapien in a Hellboy issue, who spits up quite a bit of blood after being impaled through the chest by a spear; understandable in this case, since the spear most likely punctured a lung. He gets better, though.
  • The Incredible Hulk: During the fight between Zeus and the Hulk, Zeus punches the Hulk in the stomach and he vomits up a mass of green blood.
  • MonsterVerse: In the Godzilla Aftershock graphic novel, a panel depicting the corpse of Dagon (the specimen of Godzilla's species whose bones were seen in Godzilla (2014)) indicates he was coughing up a lot of blood during his death throes. His death was caused by the MUTO eggs gestating inside him after his lost battle against the MUTO Prime, a fact of which he didn't seem to be aware.
  • Inverted in Morbius v2 #2. Morbius coughs up blood just as the wound from a shotgun blast to the chest heals and gets back up.
  • In Legion of Monsters: Morbius the Living Vampire, a girl spews up a geyser of blood as she's turning into a vampire.
  • A non-fatal version happens in Persepolis, when Marjane coughs up blood from having a severe case of bronchitis (not helped by being homeless in the dead of winter in Austria) and passes out. She's found and taken to a hospital before it turns fatal.
  • In The Punisher v7 #13 a mook is shot with a type of bullet that opens up to reveal the crab-like construction inside, which then digs its way through the victim's body. The victim ends up spraying a 2-feet-high fountain of blood from the mouth. He still manages to get up and run.
  • Robin (1993): Tim Drake starts bleeding from the mouth after being hit by a strange weapon Lock-Up had prepared ahead of their fight. He then starts bleeding from his ears, nose and nailbeds as well.
  • Santa Vs Zombies: The girl who gets bitten by a kitten in the Kitty Labs store vomits up blood before she turns into a zombie.
  • When Marv is in the electric chair in the Sin City story, "The Hard Goodbye", the first jolt fails to kill him, but it makes him spit up a mess of blood (though in the movie it may not be blood, since his blood was always shown as a bright red while the goo was black. Considering he's a smoker, he might have been chewing on the stub of a cigarette; which darkens ones' spit.)
  • Superman:
    • Red Daughter of Krypton: When Supergirl becomes a Red Lantern, her blood turns into burning-hot acid which she vomits.
    • Superman: Brainiac: Superman vomits blood after pulling out a spiked probe inserted into his digestive tract by several Brainiac drones.
    • In The Killers of Krypton, Kara collapses and starts bleeding from her mouth and nose when her ship approaches Krypton's radioactive remains.
    • When Superboy-Prime captures Mr. Mxyzptlk and tortures the hell out of him, at one point he vomits blood. Prime comments on how disgusting it is.
  • In Transformers comics, a character leaking Energon from their mouth (assuming they have one) is a frequent sign that they've taken a lot of damage.
  • Warrior Cats: The Rise of Scourge: When Tigerstar dies, he spits out a hilariously small bit of blood.

    Fan Works 
  • Abraxas (Hrodvitnon): Both of Monster X's heads suffer this, alongside a nosebleed and blood in their eyes, when Ghidorah is violently making psychic contact with them in Chapter 14, just before their body goes into a violent seizure.
  • Citadel of the Heart features this as a fact of life of Ultimorian Bizarre Alien Biology, to the point of it being fairly normal for them to experience this during combat and just shrug it off afterwards and make a full recovery later on. So far fights between Chronicler, Grandis, and Mirror M against each other or other opponents have demonstrated this fact the most of the more noteworthy repeat offenders among the Ultimorians.
  • In Cosmic Warriors, Experiment-D-U-D's mouth leaks blood after he takes a beating by Tuxedo Mask and is literally stabbed in the back by Warrior Moon.
  • In the Inuyasha fic Darkness (ankh-ascendant), Sesshoumaru gets Impaled with Extreme Prejudice and coughs blood all over the diamond spears through him. Since he's a youkai with extreme Healing Factor, this is downplayed and he manages not to die.
  • A less serious variety happens in this Digimon Adventure fanfic in chapter 4. Tai gets kicked in the face during a major soccer match and notices something's wrong when he spits out blood. He's forced to leave the game because of it.
  • One of Harley Quinn's early pro boxing gimmicks in Eight Count is biting down on fake blood capsules during her walk to the ring.
  • Fate of the Clans: K is considerably less graphic than Type-Moon works, which this can have the violence of, so this happens often. Same with how frequently people have a Cruel and Unusual Death or were Impaled with Extreme Prejudice.
  • In Power Girl story A Force of Four, Kara bleeds from her mouth when she's hit hard while battling another Kryptonian.
  • In Supergirl story Hellsister Trilogy, blood leaks from the mouth from the unconscious and usually invulnerable Satan Girl after getting hit by a magic spell.
    Below her was the unmoving, unconscious form of Satan Girl, a trail of blood leaking from one corner of her mouth, and Drang, whose magic bolt had gone through the space which she occupied a nanosecond before.
    Both were bleeding, Kara from one side of her mouth, U-Ban from a nose that had run into her knee.
  • Very prominent in I Did Not Want to Die, where the protagonist is first shot in the stomach, and realizes that he's been mortally wounded once he starts coughing up blood.
  • In In Which Guzma Is Frustrated, Nanu finds Acerola's father dying and bleeding from the mouth after his illness takes a turn for the worse.
  • After Fluttershy gets shot in A Kingdom Divided, she coughs up blood. However, she lives until napalm is dropped on the field hospital.
  • In The Lion King Adventures, it's pretty obvious that Tojo is going to die when blood starts dribbling from his mouth after Tama stabs him.
  • Happens to both Kenny and Stan in Like Pinning Butterflies.
  • Happens to Mercutio in Pattern Broke, a Romeo and Juliet fanfic.
  • How Kevin knows that Ben's not doing well after the fight with Fusion Buttercup in "Pipeline".
  • The Planets: Subverted. After installing Roy's automail arm, Winry notices that he's bleeding from the mouth. It turns out to be nothing serious. Roy just bit his tongue.
  • Happens to a villain in Power Rangers GPX after suffering from a case of Impaled with Extreme Prejudice.
  • Princess Trixie Sparkle: Trixie starts bleeding from the mouth when she's squeezed by vines.
  • In Snowed In from the Rose Redemption AU series, Steven suddenly starts to cough up blood. Since Rose no longer has her healing powers, she ends up carrying him through the storm to her healing fountain to cure him of his ailments.
  • Happens to both Patchouli Knowledge (though she was just badly injured) and Koakuma in the Touhou Project fanfic Scarlet in Black's first part.
  • Somnium: Phillip began bleeding from the mouth after awakening Aurora with True Love's Kiss. He died in her arms a moment later.
  • Stars from Home plays with this when Scott hits his head and begins coughing up blood, only to wave off concern because he really did bite his tongue. Later played straight on a mission, though.
  • In the Tamers Forever Series, Takato's deteriorating health is shown from him coughing up blood several times during Silent Sorrow. During his torture by the Kurasarimon, the author showed he was Not Pulling His Punches by using this (more so even than Takato's screams of agony).
  • This is a notable sign of the chronic disease Paul suffers from in the Pokemon fanfic Travels of the Trifecta.
  • In Buffy the Vampire Slayer/Supergirl crossover The Vampire of Steel, Supergirl vomits blood after being battered by a Kryptonian vampire.
  • A New Hope (Final Fantasy VII): Cloud coughs up blood during his first dinner at the Leonhart residence, Foreshadowing the discovery of his brain tumor.
  • In Batman fanfic Dance with the Demons, blood drips from King Faraday's nostrils when Looker -member of the Outsiders- telepathically forces answers out of his brain.
    Plastic Man merely insinuated himself between Batman and the spy and wrapped himself about Faraday like a red-clad constrictor and held him firmly. The captive was starting to convulse. A slight bit of blood dripped from one of his nostrils.
    "Be careful, Looker," said Batman. "Possible cerebral damage."
  • What If I Know Too Many Reasons I Can Be Strong?:
    • Akaza bleeds from the mouth when Tanjiro taunts him about his past at the end of Chapter 6.
    • Kokushibo not only bleeds from the mouth but from the nose when Koyuki's ghost punches him in the cheek at the end of Chapter 19.

    Films — Animation 
  • Batman: Under the Red Hood has Jason defiantly spit at the Joker during his No-Holds-Barred Beatdown. However, his spit is blood due to a collapsed lung.
  • In South Park: Bigger, Longer & Uncut after Christophe aka The Mole is severely mauled by guard dogs, shortly before he dies from his wounds he coughs up blood.
  • Haku in Spirited Away is bleeding a consistent amount after being inflicted by a curse and Yubaba doesn't even try to help him, saying he will die eventually. It is Justified since he had originally swallowed Zeniba's golden seal. And of course, he is healed by Chihiro.
  • This happens a couple of times in the movie of Watership Down:
    • When Bigwig gets caught in the snare, he coughs up blood as he chokes.
    • When Blackavar is killed by General Woundwort, he coughs up some blood before he dies.
  • Atlantis: The Lost Empire has Milo bleeding a little from his mouth after receiving a sock punch from Rourke as the latter mocks him for his successful discovery of Atlantis while trying to steal its power source and sell it for profit.
  • In Superman: Doomsday after getting punched in the stomach by Doomsday several times, Superman drops to his knees and begins to vomit up blood. It’s the first real indication that he’s in serious trouble.

    Music 
  • Gene Simmons of KISS is known for vomiting blood onstage as part of his act.

    Music Videos 
  • In the video for Trio's "Da Da Da", a waitress is stabbed in the back and reappears in a nearby TV set bleeding from the mouth while singing the chorus. Bordering on terrifying.
  • In part 2 of the Synchronicity series from Vocaloid, Rin is shown bleeding from her mouth as a sign that being a Dragon Diva is slowly eating away her life force.

    Professional Wrestling 

In general:

  • This trope will come into play when a promoter wants to sell a monster heel as particularly fearsome and brutal; one tactic will be injuring his opponent so badly he'll cause him to bleed from the mouth.

Specific matches:

  • The spark to Hacksaw Jim Duggan's feud with Andre the Giant – Duggan confronting Andre in the ring and accusing him of costing him his WrestleMania IV match, before Andre suddenly attacks him – saw Duggan headbutted repeatedly to the point he was bleeding from the mouth. Fortunately, Duggan managed to have his 2x4 handy to deliver a knockout blow.
  • Displayed by Invader #3 in WWC when Manny Fernandez decided to go into business for him self and tried to kill the man with a knee across his chest. (Fernandez and had mistook Invader #3 for Invader #1. Invader #1 had killed Bruiser Brody, 3 had nothing to do with it.)
  • Ken Shamrock once won a WWF First Blood match by making his opponent bleed internally and won when he started coughing up blood.
  • Hulk Hogan after passing out from a bear hug by Brock Lesnar.
  • Paul London after enduring multiple shooting star presses from Billy Kidman, who was sick of fans demanding he keep using the move after it injured Chavo Guerrero, Kidman then asking if they still wanted to see it.
  • Shawn Michaels after Kane crushed his throat with a chair in 2004.
  • La Rosa Negra's bleeding mouth put an exclamation point on her rematch with 'Portugal's Perfect Athlete' Shanna on SHINE 20, a discuss forearm, elevated face buster and her face literally being stood on not even being the worst of it. By contrast she hid the fact she was bleeding during her match with Notorious Nadi during the second Nova Tournament, so she could dramatically spit it out when responding to a claim that professional wrestling was fake.
  • There was noticeable blood coming from ACH's mouth during his night 1 match at ''Supercard Of Honor X". While it was hard not to sympathize with him, it was great for his opponent Adam Cole, as it sent the message he needed both to his night 2 opponent Kyle O'Reilly and the fans who would be watching their no holds barred match.

    Roleplay 

    Theater 

    Video Games 
  • Bendy and the Ink Machine uses ink as a stand-in for blood. Here are some examples where there is ink from the mouth:
  • Breath of Fire:
    • Breath of Fire: Dragon Quarter:
      • After Ryu and Bosch have ended their battle in their D-Dive dragon forms. Bosch, realizing he is defeated and can no longer control his D-Link willingly allows Ryu to finish him off by means of a claw into his chest. As Ryu holds Bosch in the air, Bosch hacks a flurry of blood into Ryu's face and his body goes limp.
      • Ryu has a very similar experience long before that — blood from a mouth and a nightmare face, as Bosch stabbed him before he went "Oh, Crap!" as Ryu started to transform.
    • In Breath of Fire IV, resident Woobie, Destroyer of Worlds God-Emperor Fou-lu has this after his Hex Nuking. In fact, it's copious enough that it also counts as a Vomit Indiscretion Shot.
    • In the manga adaptation of IV, Fou-lu has this after his Hex Nuking and after being Back Stabbed with an Evil Weapon by The Emperor Soniel. (The manga depiction is far Bloodier and Gorier than in game, and is an apparent Take That! to the outright Bowdlerization of this scene altogether from international versions of the game.)
  • Paige from Brothers in Arms Earned in Blood succumbs to this after he is wounded after an attack that vaporizes his squad leader. However, he manages to gather just enough strength to pull Hartsock to safety before dying.
    Paige: I'm....pretty fucked up here, Sarge...it took everything I had to get us here...
  • Crisis Core: Zack bled all over the place, including from his mouth.
  • In Drakengard when Inuart is impaled in the gut by Furiae, he coughs up blood before dying.
  • In the third game of the Don't Escape series, the player starts coughing blood and spits out a piece of crystal at the denouement, revealing that the crystal is growing inside you.
  • Okita Souji, from Fate/Grand Order has the same magic tuberculosis as Captain Ukitake from Bleach has, the kind that stays even after you die and turn into a spirit.
  • Happens in the Fight Night series when a boxer is knocked down, though it obviously isn't fatal. Makes sense when they're knocked down by a punch to the head. Doesn't make sense when they're knocked down by a body punch.
  • Final Fantasy:
    • In Final Fantasy XII, if you look closely, Judge Gabranth has a bit of this after the second fight with Vayne. It's the fatal kind.
    • Final Fantasy XIV has several characters that bleed from the mouth after sustaining a grave injury. Most of them die minutes later while a few others live.
    • In Final Fantasy Tactics there are several characters who die with blood from the mouth. Duke Larg and Duke Goltana both die coughing a burst of red pixels, and in his final character portrait, Islude is also portrayed as bleeding from the mouth.
    • Final Fantasy VII Remake: In the "Intermission" DLC, Sonon Kusakabe coughs up blood after Nero the Sable fatally impales him through the chest.
  • In Herofall Prodigal coughs up some during her heroic sacrifice.
  • The main character of Hyper Light Drifter is suffering from a mysterious illness and is in the area in the first place in order to Find the Cure!. Periodically, he will pause to cough up puddles of blood, usually accompanied by visual glitches appearing across the screen. Fortunately, this only happens at set times; you won't be debilitated in the middle of a fight by a gore-drenched coughing fit.
  • I Have No Mouth, and I Must Scream: Happens to Benny if he ever tries to eat anything himself. Just another side effect of AM's freaky genetic modifications to the guy.
  • In the JoJo's Bizarre Adventure Fighting Game by Capcom, if you finish off your opponent with a Super Move, you are treated to a Manga style (complete with black and white shading) close up of your opponent's face, generally with blood coming out the mouth, very satisfying to see, too!
  • KanColle: Choukai's base form has a trickle of blood from her mouth in her damaged art.
  • Used a couple of times in Last Scenario, once with the Sacrificial Lamb and once with Ortas, who turns out to be so badass that he can still manage to put up a very good fight anyway.
  • At the end of The Legend of Zelda: Ocarina of Time, Ganondorf coughs up blood as he collapses in defeat. In some versions this was changed to green.
  • Mass Effect 3: This happens a lot over the course of the game. Mordin / Padok if you betray them during the Tuchanka mission, Kirrahe if he's shot by Kai Leng, Kai Leng himself after his boss fight. Finally, this happens to Shepard after surviving a Thanix blast from Harbinger on the way to the Citadel. This is the first time the player has seen Shepard bleed, much less from the mouth, so you know he/she is badly hurt.
  • The first Mega Man X game has Zero with blood/mech fluid/oil/some red substance running from the corner of his mouth after sacrificing himself to destroy Vile's Ride Armor. Notably, he does not bleed from anywhere else despite having been torn in half.
  • In Prince of Persia: The Sands of Time, in the first few cutscenes the Vizier is shown coughing violently, getting blood in his handkerchief. Since he wasn't in a fight beforehand and this has nothing to do with his later death — either of them — it may fall under Vader Breath. Although this particular case of Blood From the Mouth is death related. Specifically, the Vizier knows he is dying, which was part of his motivation for finding the Sands, and thus immortality. I'm sure the whole ultimate-god-like-power thing also had something to do with it, though.
  • Newton Belduke in Professor Layton vs. Phoenix Wright: Ace Attorney is shown with one of these in an illustration of his corpse. It's actually poison he drank.
  • [PROTOTYPE]: During the period Alex Mercer is infected with the "Cure"/Supreme Hunter, he coughs up blood before collapsing during one of the cutscenes. This doesn't actually mean he's any weaker than he was on the previous mission, but it's a pretty big clue that if he doesn't get rid of it soon, it'll eat him alive. Yes, Alex Mercer being eaten alive.
  • Red Dead Redemption II: The earliest hint that Arthur Morgan won't survive this story is when he starts coughing up blood and collapses.
  • Resident Evil:
  • Ukyo Tachibana from Samurai Shodown is stricken with tuberculosis, so once in a while he coughs up blood in his winning poses.
  • Spec Ops: The Line: If Walker is killed by the squad sent to save him from Dubai, he will cough up blood as he lays on the ground dying.
  • In Tales of the Abyss, a trickle of blood is coming from Asch's mouth as he dies.
  • Happens fairly often in Trauma Team. This is the result of the hemorrhagic fever caused by the Rosalia virus. True to the trope, this typically means whoever is vomiting blood is nearly dead. Also tends to coincide with Tears of Blood for the same reason.
  • Seen several times in Undertale on characters who are near death, though it's mostly Black Blood (considering monster SOULs are gray). Sans appears to bleed red during his boss battle, although considering he's a skeleton and taking into account certain events on a pacifist route, it's possibly just ketchup.
  • This is all over the place in Vagrant Story. Sydney sports a few pixels of it in the very beginning, courtesy of a crossbow bolt to the lung, and then again toward the end, after Guildenstern has had his way with him. Hardin gets a bad case after Guildenstern (again) stabs him. Neither of the former two take; the latter, however, eventually does.
  • Duck from The Walking Dead begins to cough up blood when he's on the verge of death after being bitten by a walker.
  • A recurring image in the worlds of Yume Nikki, most obviously in the "Forest world", which may hint at events in the protagonist's past.

    Visual Novels 
  • Mid-way through Chapter 3 of Danganronpa V3: Killing Harmony, Kaito begins to fall ill. By the end of the chapter, he starts coughing up blood, and it just gets worse from there. During his execution in Chapter 5, he finally succumbs to this illness and dies before he can be properly executed.
  • In The Eden of Grisaia we see the ending of the flashback that began two games earlier in Amane's route. After Amane managed to escape, Kazuki stayed behind to try to keep the other victims of the bus crash alive as long as possible, hoping for rescue. By the time she could take control, there were only three girls left, the only one of whom was fit was Koide. Kazuki warned her not to take the rice and eat it directly because her body could no longer hold down solid foods and would need it prepared as gruel. However, she was starving and couldn't hold back, so after being left to prepare the next meal on her own, she was found having puked so badly that blood was coming from her mouth. Despite being the most fit girl left besides Kazuki at that point, she was the next to die.
  • Ever17 features a (usually) fatal disease called Tief Blau, the primary symptom of which seems to be coughing up and sneezing blood... until you choke to death on it, usually clawing your throat out at the same time.
  • In Fate/stay night, Shirou averts this trope, noting how minor an injury coughing up blood is after doing it by flushing out Ilya's binding spell.
  • Unsurprisingly, Okita Souji in Hakuouki inevitably starts coughing up blood as his tuberculosis sets in. In his final bad ending, he takes a sword to the chest and bleeds from the mouth (in addition to bleeding copiously from the actual wound) as he dies.
  • Terry Fawles in Phoenix Wright: Ace Attorney: Trials and Tribulations begins to bleed after poisoning himself in the middle of the court.
    • Also happens to Dhurke Sahdmadhi in Phoenix Wright: Ace Attorney – Spirit of Justice, when he gets shot in the chest three times by Inga Karkhuul Khura'in before scaring him out of his wits. You can tell that Dhurke's bleeding from the mouth as he tells Maya to channel his spirit as a Last Request while he is sitting over slumped next to the sarcophagus on the point of death.
  • In Ribbon Of Green, this is how the girl who was Dead All Along fades away.
  • In the Sega CD game Snatcher, the Benson that turns out not to be a snatcher begins to bleed from the mouth as he says his final words to Gillian. The blood is a modest drip; which is strange considering his injuries are so devastating, that Metal Gear Mk. II can't even get the words out.
  • Tsukihime: When Akiha does this near the end of Hisui's true ending, that's how you know that she's about to die.

    Web Animation 
  • This happens twice in Broken Saints: the first time to Charles, Bravado, and their men when Shandala gives them a good old Emotion Bomb mind blast; the second time to Raimi in the Grand Finale.
  • This is Glitchtale's preferred way of depicting serious internal damage, though it's almost never fatal due to the amount of healing magic present in the setting.
  • In My Jungle Book, Your Year Demonica coughs up blood in the Flash Forward of episode one while being chased by Furi.
  • In RWBY, after getting stung by Tyrian's scorpion tail, Qrow begins coughing up blood tainted purple like the poison was.
  • In Madness Combat:
    • Jebus gets infected by a virus in Inundation, which makes him occasionally puke blood. It doesn't slow him that much.
    • Expurgation start with a red figure falling somewhere in a hellish location who repeatedly puke up blood or fire or both since we don't know what this character is made of.
    • In Powerless.fla, Deimos who's already pretty beaten up and even lost his lower jaw, vomit the same black goop that have been serving as his blood since he got in hell.

    Webcomics 
  • In Champions of Far'aus, After fighting a dragon, Catharine starts coughing up blood. She quickly bids goodbye to Daryl and Flamel, and flys away in her amorphous form, which pauses the bleeding. She appears to have healed up by her next appearance.
  • In Clockwork Game, William Schlumberger has Black Vomit, in which someone pukes up partially digested blood. It's the final stage of Yellow Fever.
  • Seen a few times in Dominic Deegan: Oracle for Hire. In one of the more memorable instances, Szark's infernal wound acts up and causes him to yark blood in his parents' living room. It's the last thing Dominic needs. It's non-fatal, though, and he even apologizes for the carpet he ruined.
  • In Earthsong, when Beluosus finally crushes Skogul's soulstone for revenging herself on the person he needed to carry out his plan, she coughs up blood as she falls to the ground.
  • In Girl Genius, Doctor Vg after a Mercy Kill, as a revenant interprets a vague command as a direct order to activate a deadly weapon, and wishes to spare his friend the coming horror.
  • In the webcomic Gnoph, Abbey is constantly coughing up blood as a side-effect of the symbiote living in her lung. It's actually referred to by its medical name, hemoptysis.
  • In Hanna Is Not a Boy's Name, Hanna throws up quite a bit of blood pretty early on in the story. Subverted in that he doesn't die / isn't apparently dying and is pretty fine afterwards.
  • Page 627 of Haru-Sari has June throwing up a LOT of blood.
  • Homestuck:
    • Five instances so far. Later on, during [S] Cascade, Sollux would start bleeding from the mouth from the stress of psychically moving the trolls' asteroid to the green sun. In this case, the blood from the mouth was just part of the damage, as a lot of the veins on his face were bursting at the same time.
    • And a sixth time, though in this case, it's more a matter of getting conked on the head and spitting out teeth than any kind of serious injury.
    • Gamzee spends roughly the entirety of Act Six Intermission Four gushing blood from his mouth after being shot.
  • Seen in Juathuur here. He survives, barely.
  • Seen in Misfile when Rumisiel discovers Raechiel's body.
  • In Mitadake Saga, Koji spits up blood after being stabbed.
  • Nuzlocke Comics and spinoffs thereof frequently use this to indicate that a Pokemon has been fatally injured.
  • Valeska Köhler in Panthera, as seen here.
  • Fairly common so far in Shadownova, despite the comic still being fairly new. So far it seems to be justified in most cases. Karen is impaled on a pointy bit of metal and while Carver and Scruffy both only seem to have light external injuries when you consider that the both crawled out of the wreckage of a destroyed building damage from shockwaves and hits from falling debris isn't really a stretch. In Cam's case it's made obvious it's just a split lip.
  • In Sidekicks most characters throw up blood when they take severe or fatal damage and injuries.
  • Slightly Damned:
    • When Darius comes across Buwaro's dying biological father, the demon vomits blood when attempting to threaten Darius. Years later when Darius is fatally injured he vomits blood when talking then comments on how he's not so different from Buwaro's dad.
    • When Kieri fatally stabs Berserk Lazuli in the side to save Rhea, drops of blood spray out of the dying demon's mouth as she screams.
  • In UC, after a group of bullies beat the living daylights out of Nicodemus, he begins to cough up blood. It’s just a result of his broken nose bleeding into his lungs, and he most certainly does not need to go to the hospital, thank you very much, Kelsi.
  • Wylie in Undead Friend has been seeing coughing up blood and it seems to be tied to a certain mirror he owns.

    Web Videos 
  • Evan from Everyman HYBRID tries to kill the goddamn Slender Man with a baseball bat in "Ashen Waste". The screen goes black, and the next thing we see is him staggering around bleeding from the mouth.
  • A YouTube video which purports to be a real execution shows a man in the electric chair who starts bleeding from the mouth when the first jolt hits him. Several comments on the video note that the "execution" was, in fact, staged as part of a TV documentary on prison life.
  • In the YouTube phenomenon "Blood", a toddler accidentally hits his infant brother in the face while playing, splitting his lip and causing him to bleed. The toddler becomes extremely distressed upon seeing his brother bleeding, and tries to tell his dad that there's blood on his brother's face. Hilarity Ensues.
  • Parodied in CalebCity's "If people from anime took their bleeding serious". One characters gets hit, coughs up blood, and then immediately calls off the fight and asks for an ambulance because he probably broke a rib or caused internal bleeding or something dire. The other character says that it's not serious a and to prove it punches himself gently in the stomach which causes him to cough up blood.

    Web Original 
  • A metaphorical use can be seen here, where pent-up anger is a cancer and this is seen, along with tumors. Apparently, the artist draws a lot of those to convey her feelings, negative feelings that is.

    Western Animation 
  • Adventure Time: "Obsidian" reveals Marceline's mother knew she was dying when her cough worsened into this.
  • Arcane: After the time skip, Viktor's constitution has deteriorated to the point where he will sometimes cough up blood. Doing this and observing his blood reacting with a Hextech Gemstone makes him learn of its ability to react with organic matter, resulting in him developing his present-day Hex Core.
  • In The Boondocks during fight scenes characters will often cough or spit out blood.
  • The DCAU was pretty loose with this - one gets the impression that Batman must have had internal organs with incredible regenerative properties, given how many times he's had blood running from his mouth and not died. More reasonable to assume it's a split lip, or accidentally biting his tongue or cheek hard enough to draw blood when he gets hit, especially since they seem to come more often after blows to the face. His mouth is the only visible part of his body. This was even Lampshaded at one time in a comic where after fighting Clayface, an unmasked Bruce showed he had received a black eye from their confrontation, (as well as several other bruises around his chest and torso); something that his Expressive Mask covered up.
  • Family Guy: In "New Kidney in Town", Peter skips his dialysis to go to the Drunken Clam. This turns out to be a terrible idea, because he gets jaundice and vomits up a good deal of blood.
  • In an episode of Metalocalypse, Nathan vomits blood after seeing the others vomit. It turns out he has a bad liver, getting it replaced later on. This prompts Toki to make a note that "Blood Puke" is a good name for a song before remembering they already wrote it.
  • Amazingly, this happened a few times in The Powerpuff Girls (1998):
    • In the episode "Bubblevicious", Bubbles is trying to prove she's hardcore, and so turns up the difficulty of the this-episode-only-training-chamber. After taking a significant beating from the simulations (somehow), she has a small trickle of blood running from her mouth (though the lighting purposefully makes this difficult to see), which she wipes off, right before unleashing all hell on the simulated monsters. Beware the Nice Ones, indeed.
    • In the intro, Him spits out a bunch of teeth and a little blood from a kick in the face from Buttercup, though it could be coming from his nose.
  • The Simpsons:
    • In "Brother from the Same Planet," during Homer and Tom's fight near the end, blood is dripping from Homer's mouth before he is knocked onto a fire hydrant.
    • When special-effects master Tom Savini visits the Android's Dungeon in "Worst Episode Ever," he secretly hides a time-release blood pack in a cookie as part of his show. An unimpressed Comic Book Guy eats the cookie and is mortified when blood starts gushing out of his mouth.
  • Happens in Superman: Doomsday after Doomsday punches Superman in the stomach several times, with some of the blood splattering across Lois Lane's face. It's at this point that she and Jimmy Olsen fully begin to realize that Superman could be in grave danger.
  • Happens to Lance in Sym-Bionic Titan after getting a Jack Bauer Interrogation Technique onboard G3's ship. Although it appears to be black blood, it's still quite shocking when you consider this show originally aired on Cartoon Network (which made it less out-of-place on Toonami).
  • The Transformers:
    • In Transformers: Prime Cliffjumper bled Energon from the mouth, shortly before Starscream ripped him open.
    • Optimus Prime's beatdown of Megatron in the season 1 finale had Megatron leaking energon from his mouth. The Transformer equivalent of blood. https://www.youtube.com/watch?v=9NQ-h3FpjR8
    • In Transformers: The Movie, Prowl starts bleeding smoke from his mouth just before he collapses dead.

    Real Life 
  • Attila the Hun actually died this way. It's unknown exactly why he died but he was found drowning in his own blood.
  • Truth in Television for anyone who's done high school wrestling, in which it's common for wrestlers to be wearing metal braces, and one of the principal moves is the cross-face, which is basically a jab across your opponent's mouth. There are mouth pieces designed to prevent this, but most eschew them because it makes it harder to breathe. Most teams have, during a match, at least one person on duty just to clean up blood from the mat.
  • When President Ronald Reagan was shot in 1981, the Secret Service agents whisking him away didn't immediately know he had been hit—until he started spitting up blood, whereupon the limo was diverted to the hospital. Reagan survived a bullet wound in his lung.
  • When Archduke Franz Ferdinand was shot by Gavrilo Princip at Sarajevo in 1914, the fatal bullet entered the Archduke's neck under his tunic collar, severing his jugular vein and badly damaging his trachea (windpipe) before lodging in his spine. This caused blood to spray out forcefully from his mouth, striking one of his staff officers in the cheek. His wife, Duchess Sophie, saw that and cried out, "For heaven's sake, what's happened to you", before collapsing to the floor of the automobile, the victim of a bullet in the abdomen which caused her death within minutes from massive internal bleeding.
  • In one account of the execution of the Imperial Romanovs in July 1918, one of the younger grand duchesses, likely Anastasia Romanov, was found by soldiers to be still alive and bleeding from the mouth, making strange "guttural sounds" - either from being shot in the head or from being bayonetted alone; in spite of the jewelry sewn into their clothing protecting Tsarevich Alexei, the Tsarina and the grand duchesses that might have spared them a few lethal blows, Ermakov's persistent bludgeoning with a bayonet still did enough damage that it caused "streams of blood" to fly through the air and break the ribs and floorboards underneath the unfortunate victims who happened to find themselves at the other end of his bayonet, until Yurovsky - the captain in charge of the execution and trying, in vain, to keep it clean - was said to intervene and attempt to mercy-kill Ermakov's victims by shooting them in the head.) Regardless of how or why the mouth-bleeding, this was apparently a horrifying enough sight that some of the soldiers, already sickened by the rivers of gore and cordite smoke they were having to wade through, ran out of the room to throw up themselves.
  • Several serious lung conditions, including pleural effusion (fluid in the lung cavity) and pneumothorax (air between the lung and the chest wall, collapsing the lung) present with pinkish-red, frothy sputum as a critical sign. When a patient actually bleeds from the mouth, it's usually from ruptured esophageal varices (swollen, fragile blood vessels in the esophagus) in the context of liver failure. Neither situation is anything to laugh off, as you can't breathe with a collapsed lung, and you can lose a major portion of your blood volume from bleeding varices very quickly.
  • Blood from the mouth, mixed with mucus, is a symptom of tuberculosis.
  • During rioting following the 2009 Iranian election, a woman named Neda Soltan received a bullet wound in the chest and died. A cell phone camera video taken of her immediately after being shot received major international attention. The video clearly shows her bleeding from the mouth and nose. And not the little dribble of blood normally used in the trope either. There was a lot of bleeding from the mouth involved.
  • Similarly, the suicide of R. Budd Dwyer was caught by national news cameras, as he'd shot himself through the roof of his mouth with a pistol at a press conference. There was about as much blood streaming from his nose as his mouth.
  • Mughal Emperor Shah Jahan I invoked this to avoid an assassination/usurpation attempt by his stepmother Empress Nur Jahan. He faked an illness over a period of about three weeks while various officials of the court visited him. On the morning of day one of the closest to his stepmother visited, he allegedly drank three goblets of goats blood, then vomited it up while the official was with him, faking his death well enough to fool the doctors attending him.
  • In real life, if blood comes from the stomach, it's a brown color, and can be mistaken as a large amount of coffee grounds, bearing no resemblance to "common" human blood. This is one of the common signs of an ulcer in the stomach.
    • One exception to this is if there is a sudden, rapid hemorrhage, in which case the blood that would come forth would likely be dark red, with specks of reacted black, because the bleeding would be so rapid there would be no time for the stomach acid - or, in fact, enough stomach acid there to begin with - to react with all of the blood to make it turn brown if it were a lighter bleed. Usually, a non-traumatic bleed this bad would implicate a dilated artery, such as in portal vein hypertension.
  • This often happens to people who tend to get bad nosebleeds. Blood trickles into the throat, and the person spits it out. Also happens to some people who get bad nose-colds that TURN into nosebleeds, due to dehydration, a chapped nose, or other causes.
  • When the battleship Prince of Wales was hit during her duel with the Bismarck, the staff in the combat centre beneath the bridge found blood dripping from the voice-pipes. It was Captain Lynch, the only survivor on the bridge, and he got better.
  • A blow to the Adam's apple (aka, that lump on the center of a man's neck) can likely cause internal bleeding and forces the victim to cough out blood. It can be fatal if done with sufficient force.
  • As shown in Untold Stories of the E.R. this happens to trauma patients. One patient was violently coughing blood and they could not figure out how. Turns out he had accidentally inhaled a push pin that had fallen from a poster his tenant had put up. And the coughing was causing it to shred more of his lung.
  • Theodore Roosevelt used the absence of this trope to determine that he didn't need surgery to remove an assassin's bullet, understandably concerned given that his predecessor had died from such a surgery.
  • The British Museum in London has a series of bas relief of lion hunts from ancient Assyria. They are incredibly clear and beautiful, and several of the dying lions show this trope. Since these date to about 650BC, they make the trope Older Than Feudalism.
  • Rabies can cause this indirectly because sufferers often go through a violent stage that makes them try to bite people, and so their mouths get bloody AND foamy.

 
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Hornblower: The Even Chance

The duel between the Big Bad and the protagonist's best friend takes a surprise turn for the worse.

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