Spitting out very thick black bloody sputum in the morning without coughing may be related to old hemorrhage caused by bronchial rupture, and is considered to be a respiratory disease such as tuberculosis and lung cancer. If the black bloody sputum is spit out from the mouth caused by gastrointestinal bleeding, it is considered to be digestive system diseases such as peptic ulcer, stomach cancer, etc. Different treatments are needed for different causes. Different treatments are needed for different causes. 1. Tuberculosis: if accompanied by low fever, night sweating, fatigue and other symptoms, most of them are caused by tuberculosis, which is often treated with anti-tuberculosis drugs such as isoniazid, rifampicin and pyrazinamide. 2. Lung cancer: If there is a small amount of fresh blood in black sputum, it may be caused by lung cancer. At the same time, some patients may have symptoms such as chest tightness and shortness of breath. Common treatment drugs include gemcitabine, paclitaxel, pemetrexed and so on. Surgical methods include total pneumonectomy, bronchoplasty lobectomy, etc. 3. Peptic ulcer: If there are repeated episodes of epigastric pain, with a certain periodicity and rhythmicity, it is mostly peptic ulcer, and duodenal ulcer is the most common. Commonly used acid-suppressing drugs such as omeprazole, gastric mucosal protective agents such as magnesium aluminum carbonate and other drug therapy. If necessary, endoscopic treatment can be given to stop bleeding. 4. Gastric cancer: middle-aged and old people with chronic epigastric pain, pain without obvious regularity and accompanied by anorexia, emaciation or anemia should be alert to gastric cancer. If there is no lymph node metastasis in early gastric cancer, endoscopic mucosal resection or endoscopic submucosal dissection can be adopted; if there is no systemic metastasis in progressive gastric cancer, surgical treatment is feasible; gastric cancer can also be treated with chemotherapeutic drugs such as fluorouracil. Thick black bloody sputum in the morning can also be caused by other diseases. If such symptoms occur, it is recommended to consult doctor in time, complete the examination and treat under doctor’s guidance, and do not take medication without authorization in order to avoid delaying the condition.