Thanks for your question on Health Care Magic. I can understand your friend s situation and problem. He is having hemoptysis (blood in sputum) and his hemoptysis is heavy and severe. His chest x ray is suggestive of spots. So possibility of lung Infection like pneumonia, tuberculosis is more. Another possibility for his symptoms is Pulmonary embolism and bronchitis. So better to consult pulmonologist and get done PFT (Pulmonary Function Test), sputum examination and CT thorax to rule out above mentioned possible causes. Better to first diagnose him and than start appropriate treatment. Hope I have solved your query. Wishing good health to your friend. Thanks.