TREATMENT. 287 



the maintenance of the blood-conduits in a healthy and 

 tonic condition, thereby lessening the tendency to effusion, 

 the characteristic local feature of the disease. There are, 

 it may be, many cases where the earliest efforts must be 

 directed to remove certain evil results which have attended 

 early symptoms, as blood extravasations and effusions in con- 

 nection Avith certain internal organs and structures, Avhich, if 

 not relieved, would still farther complicate and render more 

 serious existing conditions. When, however, these are 

 relieved, the first object of attention must be the cause or 

 source from which these have proceeded : the morbid state of 

 the blood and vascular system. This in every case is not 

 readily accomplished or attended with equal certainty, the 

 adverse conditions being most refractory in cases where 

 previous disease has lowered the vital force, disturbed assimi- 

 lation in some of its many steps, and where exhaustion exists as 

 an established condition. When speaking of the pathology of 

 the disease we noticed the fact that it is extremel}^ probable 

 that all forms of purpura may not be dependent on precisely 

 the same conditions or combinations, and that there seems good 

 reason to regard these as susceptible of amelioration by some- 

 what different modes of treatment. This may to a certain extent 

 explain the varying opinions given by different practitioners 

 with regard to the employment of the same agents and modes 

 of management, for in this respect there is much divergence 

 of opinion, which, concerning what might otherwise be re- 

 garded as simple matters of fact, is otherwise inexplicable. 

 In undertaking the treatment of any cases of purpura, it is 

 desirable for the success of our therapeutic treatment that 

 good sanitary conditions be enforced; for apart from any 

 consideration as to the power of indifferent sanitation 

 under certain states of inducing this disease, there is the 

 established evidence of fact and observation, that there is 

 probably no abnormal state of the horse in which the animal 

 is more susceptible of being acted upon unfavourably than in 

 purpura. 



A number of cases evidently closely connected with the 

 fibrinogenous and other colloid elements being in a peculiar 

 and excessive state of solution, together with an excess of 

 water in the blood, seem most successfully treated by the 



