PURPURA H.EMORRHAGICA. 815 



plants, especially that of the order of crucifera, such as water-cresses, 

 cabbage, mustard, radishes, horse-radishes, spoon-wort (scurvy-grass), 

 and the like, is extremely beneficial, while the extracts of the same 

 plants are quite useless. The healing effect of a fresh vegetable diet 

 upon scurvy is much more positively ascertained than is the depend- 

 ence of the disease upon a want of such nourishment. Next in virtue 

 is the juice of certain acid fruits, especially that of lemons and 

 oranges, although that of cherries, currants, apples, and the like, is 

 also serviceable. The mineral acids are of no benefit whatever. The 

 bitters and aromatics, also, are of a questionable and certainly of a 

 very secondary value. The barm of beer, also, has a great reputation 

 as an anti-scorbutic, when given to the amount of six or eight ounces 

 daily. It is very important that the rules as to diet and regimen, laid 

 down above, in treating of the prophylaxis, should be carefully ob- 

 served. The local treatment of the sore mouth has been discussed 

 already. For the ecchymoses and infiltrations, lotions and compresses 

 wet with aromatic vinegar, spirits of camphor, and the like, may be 

 applied. The haemorrhages and internal inflammations are to be 

 treated upon general principles, due regard always being had to the 

 prostrate condition of the patient. 



CHAPTER III. 



PURPURA HJEMORRHAGICA THE " MORBUS MACULOSUS " OF 



WERLHOF. 



ETIOLOGY. The symptoms of the spotted disease of Werlhof re- 

 semble those of scurvy, as far as regards the appearance of extravasa- 

 tions of blood from the capillaries of the skin and mucous membrane ; 

 but the haemorrhages are not accompanied by any affection of the 

 mouth, nor by the peculiar subcutaneous and intermuscular infiltra- 

 tions, nor the haemorrhagic inflammations of the serous membranes, 

 which we know to be symptoms of scurvy. 



The reason for the tenderness of the capillaries in Werlhof *s dis- 

 ease is obscure. The extension of the haemorrhages over various parts 

 of the body, its frequent occurrence among feeble and debilitated per- 

 sons, and among convalescents from severe illness, and its appearance 

 in those who dwell in damp, unwholesome lodgings, or in other unfa- 

 vorable conditions, make it probable that the disease of the blood- 

 vessels depends upon an improper state of this nutrition, or upon 

 insufficient or bad nutriment. On the other hand, robust, powerful 

 jidividuals, living under the most advantageous circumstances, and 



