216 Purpura Hemorrhagica. 



Literature. Hofer, Eepert., 1852, XIII, 201. — Hiirlimann, Schw. A., 1896, 

 120.— Klett, D. t. W., 1899, 43.— Scheibel, B. t. W., 1899, 73.— Albrecht, D. t. W., 

 1899, 189.— Zschokke, Schw. A., 1900, 241.— Mattel, O.- M., 1900, 491.— Tremmel, 

 T. Zbl., 1900, 454.— Wohlmuth, T. Zbl., 1905, 113. 



9. Purpura Hemorrhagica. Morbus maculosus equorum 



(Petechial fever, Acute haemorrhagic-anasarcous toxemia. 



Typhus equorum, Anasarque essentielle ou idiopathique, 



[French^; Blutfleckenkrankheit der Pferde, [German]; 



Febbre petechiale, Morbo maculoso, [Italian'].) 



Purpura hemorrhagica represents an acute, non-infectious 

 disease or process, probably caused by a septic bacterial intoxi- 

 cation, as a sequel to a specific infection. It is principally 

 characterized by extensive edematous infiltrations of the scb- 

 cutaneous connective tissue, and by hemorrhages in the swell- 

 ings as well as in the mucous membranes, and in the internal 

 organs. 



History. In olden times the disease was grouped amqng the 

 putrid fevers (Febris putrida) or with the typhus affections (horse 

 typhus), and it was thought to be essentially a primary decomposition 

 of the blood. Later it was considered by some to be a form of anthrax 

 (Roell), by others an affection related to scarlet fever of man (Perci- 

 vall, Zschokke). Hering (1841-1850) recognized, its non-infectious 

 nature and at the same time separated the disease as an independent af- 

 fection (petechial fever) from other similar ailments. Recently the idea 

 became generally accepted that the disease is to be taken as an intoxi- 

 cation caused by bacterial toxins (Dieckerhoff, Lignieres and others). 



The names given at the present time to the disease (petechial 

 fever, Hering, purpura hemorrhagica) are based upon important 

 symptoms, particularly the hemorrhages into the mucous membranes. 

 The designation of horse typhus which was used in former times does 

 not appear to be appropriate, as the disease differs decidedly from 

 typhus affections of man, and especially from the abdominal typhus. 



Occurrence. The disease usually occurs sporadically, but 

 many cases may appear within a short time, especially in stables 

 where, influenza and strangles have existed. The disease is 

 of importance on one hand because of its frequently fatal ter- 

 mination, and on the other hand by the very slow course and 

 the loss sustained by the continued disability of the patient 

 for work. 



Aeeording to Javorsky in 1892-1901, 544 cases occurred in Moscow; the mor- 

 tality among the animals received in the city hospital was as high as 0.3 to 0.8%, 

 the average being 0.42%. 



Etiology. Purpura hemorrhagica with rare exceptions 

 develops as a secondary affection, as a sequel to diseases in 

 which suppuration or necrosis of tissue have occurred in any 

 part of the body. Such diseases are especially strangles, pneu- 



