Licence: Public Domain Mark
Credit: The practice of medicine / by Thomas Hawkes Tanner. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
83/1216 (page 73)
![all kinds. A great deal may also be done to lessen the monotony of long evenings, by supplying interesting books, music and singing, and drafts or chess, or backgammon; while private theatricals form an almost endless source of amusement, what with the rehearsals and different arrangements which such performances of necessity entail. III. PURPURA. This disease probably consists of some morbid state of the blood and capillary vessels; though the precise nature of the alteration, in its early stage, is unknown. The result is, however, that the red blood corpuscles become disintegrated, while the contents of these cells are of course dif- fused. Hence purpura [so called from Jlopyupa — a purple dye] may be said to be characterized by the occurrence of sanguineous effusions into the cutaneous and mucous tissues of the body; producing red or claret- colored maculae, which die away to be succeeded by fresh eruptions in adjoining patches of skin. When the hemorrhagic spots are very small, they are termed petechise ; when larger, perhaps owing to the fusion of several petechise, they are known as vibices; while where there are con- siderable patches of extravasated blood, the blotches are spoken of as ecchymoses. All these marks have this character in common,—they do not disappear or fade on the use of pressure. Purpura was placed by Willan in the class of exanthematous diseases. He enumerated five varieties of it. These are purpura simplex, p. urti- cans, p. hemorrhagica, p. senilis, and p. petechialis or contagiosa. Such a subdivision seems, however, to be a very unnecessary refinement. It is sufficient to adopt the two old divisions generally employed in the present day,—viz., that of purpura simplex and p. haemorrhagica. The first is frequently a trifling affection ; which has its origin in mal-assimilation, and can usually be soon corrected. Not so with the second va^rietjr. For in addition to the cutaneous hemorrhage being frequently considerable, the blood is often poured out freely beneath the mucous membranes; while if there be much degradation of this fluid, copious effusion may take place into the serous cavities, the stomach and intestines, the air- tubes, or the bladder, &c. The causes of purpura are obscure. Sometimes it seems clue to the excessive use of salt provisions, or of pork preserved in nitrate of potash. The disease known as black leg, which occurs amongst the lumber men on the Ottawa or grand river of Canada, is merely a form of purpura; being produced by a diet of bread with tea, and pork saved from decom- position by packing in saltpetre. In several instances the origin of pur- pura can be traced to insufficient food, with the other ills of poverty; to chronic exhausting affections ; to ichorhaemia; to degenerations of the liver or spleen; to Bright's disease; to intemperance; and to long-con- tinued mental anxiety. One of the most troublesome cases, as regards](https://iiif.wellcomecollection.org/image/b21079961_0083.jp2/full/800%2C/0/default.jpg)
