166 SPECIAL EQUINE THERAPY 



In fact, the more experience one has with this disease, 

 the less does he marvel at the appearance of complica- 

 tions of any sort. One may expect anything in a case of 

 purpura hemorrhagica. As has already been pointed out, 

 the resisting power of the animal is at a low ebb. 



Differentiation. Purpura hemorrhagica is not easily 

 confused with any other afEection. In cases in which the 

 swellings appear in spots it must be differentiated from 

 urticaria. Examination of the visible membranes will 

 disclose patechiae in cases of purpura hemorrhagica, 

 whereas in cases of urticaria these are absent. Violent 

 pruritis common to urticaria is not exhibited in purpura 

 hemorrhagica. The swellings of urticaria are transient, 

 lasting at most a day or two. The purpural swelling 

 becomes more pronounced during this time. 



Treatment. My experience with purpura hemorrha- 

 gica has shown it to be a self-limiting disease, the treat- 

 ment of which is chiefly symptomatic. I have not been 

 able to abort or shorten the duration of cases by the use 

 of treatments that have been reported as doing this. In 

 my experience I have found that it requires about one 

 month for a well developed case of this disease to run its 

 course to a favorable termination. Very mild cases may 

 recover in half this time. 



I would place the rate of mortality at about forty per 

 cent in the well marked cases, and at about twenty-five 

 per cent in aU cases. This death rate can not be said to 

 be direct, because most of these animals die not from pur- 

 pura hemorrhagica, but from complications incident 

 thereto. 



Human patients have been recently reported promptly 

 cured of purpura hemorrhagica by the intramuscular in- 

 jection of large quantities of fresh blood. While I do 

 not believe that this disease in human beings is the same 

 as that which veterinarians find in their patients, I would 



