A case of rheumatic purpura : with notes / by J. Wickham Legg.

  • John Wickham Legg
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: A case of rheumatic purpura : with notes / by J. Wickham Legg. 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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    and muscles caused by fever appears to be the same as that caused by tlie ageuts s])oken of iu the next paragrapli but one, (iii.,) pbos[)boriis, alcohol, and others. 1 urpui’a iu typhoid fever is thought to be a dangerous couiplicatiou, and nearly all the cases recorded have proved labil. Scliueschkow has, however, lately published a case in which purpura appeared on the sixteenth day of typhoid fever iu a child of six; the attack was severe, bleedings taking place from the nose and mouth, under the skin, with the urine and stools; pains were felt in the right knee. On the2istday of the fever the bleedings ceased, and the patient made a good recovery.^ Some years ago I was asked to see a little girl suffering from purpura and epistaxis during the progress of whooping-cough. The patient did well. I see that a case of the same kind has been lately recorded iu Italy. But Walker, so long ago as i797> printed a case of a hmmorrhagic diathesis coming ou and disappearing during an attack of whooping-cough.^ (ii.) Next to the infective, we may put the toxic, purpura, which follows the action of so many drugs and poisons, including snake-bites.® It would be a hard matter to make a complete enumeration of the drugs which cause haemorrhage as ])art of their physiological action. That this was a property of iodide of potassium and bromide of potassium has long been known. Ordinary kitchen-salt also })ossesses this power, and the mode in which it acts has also been made out. It causes hsemor- rhage per diapedesin. Prussak injected a 2 per cent, solution of chloride of sodium into the lymph sac of frogs, and found that the red coi i)uscles began to escape through the uninjured vessels, and to be visible in the tissues around. He also injected daily a certain quantity of chloride of sodium into the connective tissue of a rabbit, and after death numerous ecchymo.ses were found in all the oi'gans.^ The experiment on the frog I repeated many times with success in 1871. A crystal of chloride of sodium was put under the skin, and the circulation iu the web of the foot watched under the microscope. The red corpuscles were seen applying themselves to the sides of the capillaries, escaping through the wall, and they became visible in the tissues ^ Schneschkow, Medicinskoje Obosreiiije, i88i, Feb. abstract in Centralblatt f. klin. Med. Bd. ii. 1882, p. 163. * Walker, Duncan’s Annals of Medicine for I797> ''’ol. ii. p. 231. 3 Dr. Weir Mitchell thinks the hsemorrhage in snake-bites and in yellow ferer to be due to the weakened vessels. (American Journal of the Medical Sciences, 1869, vol. Iviii. p. 120.) Prussak, Sitz.ungsberichte der math.-naturw. Classe der kaiserl. Akad. der
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