An obstinate case of purpura hemorrhagica / by J.H. Burch.

  • Burch, John Holcomb.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: An obstinate case of purpura hemorrhagica / by J.H. Burch. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    T3 hemorrhage from the nose. The urine was again nor- mal, containing neither bacilli, casts, nor albumin. The diazo reaction and indican were still absent. The follow- ing was the blood-count per cubic millimeter: Red cells, 3,800,000; white cells, 13,500. From that time on the condition of the patient very gradually improved. The blood-count revealed an in- crease in number of red cells from day to day, and the character and appearance of the cells changed for the better. The leucocytosis diminished also, the small mononuclears greatly predominating. The purpuric spots gradually disappeared, and on the 26th of March I saw her for the last time, she being at that time con- valescent. She is now a well and healthy girl. The treatment in this case consisted of the administra- tion of strychnin sulphate, which I used as soon as as- thenia became manifest. I began with -fo of a grain, and increased to -J- of a grain, every three hours. For the hemorrhagic condition I employed aromatic sulphuric acid, 10 minims every three hours, and ergotin, X of a grain every three hours. For the impoverished blood state I used arsenic in the form of Fowler's solution, 2 minims every three hours, and after the degenerated con- dition of leucocytes became so marked I prescribed nu- clein (Auld’s), one tablet every two hours. This, with small doses of brandy at ‘times, as indications for its use arose, comprised the treatment throughout the case. I will here mention that after prescribing nuclein for thirty- six hours I detected a difference in the appearance of the polymorphonuclear cells. They increased in number, were of smaller size, and the degenerated condition, which had before been present, gradually disappeared. Still, it is difficult to assure one’s self that this result was brought about by the nuclein, and I mention it only for the reason that the drug was prescribed, and the change became manifest after its exhibition.
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