P U fl 



PUR 



the attack, the acuteiiefs of the pains in the internal ca- 

 vities, the aftiial iiiflar.imatory fymptoms that lometimes 

 fuptrvene, the occafional removal of the difeafc by fpoii- 

 taneous haemorrhai^e, the frequent relict derived from arti- 

 ficial dilchargcs of blood, (fee two cafes of purpura by 

 Dr. Parry, Edin. Med. and Surg. Journ. for Jan. 1809), 

 and from purging, all tend to excite a fufpicion that fome 

 local vifceral congeltion or obltruiflion is the caufe of the 

 fymptoms in different inftances." (Bateman's Praft-cal 

 Synopf. of Cutan. Dif. p. no.) Several fatls in proof of 

 thefe oblervations are itated in the work juil quoted ; but 

 a fufficient number has not yet been collected to afford any 

 general inference refpefting the usture of the difeafe. 



The cure of purpura is, therefore, not eftablifhed upon 

 any clear prmciple, and there has beea confiderable differ- 

 ence of opinion upon the fubjeft. Dr. Willan has given 

 a very imperfeft view of this point. All that he fays 

 relative to tlie cure of the worft form of purpura, is com- 

 prifed in thefe few lines. " In tlie treatment of this dif- 

 eafe, we fhould recommend moderate exerciie in the open 

 air, a generous diet, and the free ufe of wine, Peruvian 

 bark, vitriolic acid, &c. Without air, exercife, and an eafy 

 ftate of mind, the effeft of medicines is very uncertain." 

 (On Cutan. Difeafes, p. 461.) Of this, indeed, he has 

 given an ample proof in the next fentence, where he tells 

 us that a patient " took for two or three months Peruvian 

 bark in confiderable quantities, the vitriolic and marine 

 acid, and wine, without much advantage." In trnth, the 

 cure of purpura is, we believe, not to be effected by thefe 

 means. In the (lighter degrees ^f the difeafe, occurring 

 in children who are ill fed and nurfed, and excluded from 

 the air and from all exercife, thefe tonics may feem to do 

 good, when combined with air and exercife. " But," as 

 Dr. Bateman obferves, " when it occurs in adults, efpecially 

 in thofe already enjoying the benefits of exercife in the air 

 of the country, and who have fuffered no privation in refpett 

 to diet ; or when it appears in perfons previoully fl:out, or 

 even plethoric ; when it is accompanied with a white and 

 loaded tongue, a quick and iomewhat {harp, though fmall, 

 pulfe, occaofinal chills and heats, and other fymptoms of 

 feverifhneis, however moderate ; — fymptoms which may be 

 prefumed to indicate the exiltence of iome local congeftion ; 

 — then the adminiftration of tonic medicines, particularly 

 ot wine, cinchona, and other warmer tonics, will be found 

 inefficacious, if not decidedly injurious. In fuch cales, free 

 and repeated evacuations of the bowels, by medicines con- 

 taining fome portion of the muriate of mercury, will be found 

 moft beneficial. The continuance or repetition of thefe 

 evacuants muft, of courfe, be regulated by their effedts 

 on the fymptoms of the complaint, or on the general con- 

 Ititution, and by the appearance of the excretions from the 

 inteftines. If the pains are fevere and fixed, and if the 

 marks of febrile irritation are confiderable, and the fpon- 

 taneous haemorrhage not profufe, local or cjeneral blood- 

 letting may doubtlefs be employed with great benefit, ef- 

 pecially in robuft adults." Praft. Synopfis, before quoted, 

 p. 114. 



The importance of free purgation in purpura has been 

 clearly flated in a {hort but valuable communication from 

 Dr. Harty, of Dublin, publifhed in the Edinburgh Medical 

 and Surgical Journal, for April, 1813 : in more than a 

 dozen cafes treated in this manner by Dr. Harty, the 

 hemorrhages ceafed, and the purple fpots difappeared, after 

 a few dofes of calomel and jalap had been taken. In the 

 two cafes related in the fame ufeful journal by Dr. Parry, 

 of Bath, before alluded to, and which were fpeedily cured 

 by two bleedings from the arm, the blood drawn exhibited 



a tenacious contracted coagulum, covered with a thick 

 coat of lymph, as in difeafes of an inflammatory nature. 

 The patients were a lady and an officer, the latter of whom 

 was accullomed to free living ; in botli cafes fome degree of 

 feverilhnefs accompanied the purpura. 



There is one variety of the difeafe, which Dr. Willan dif- 

 tiuguiflied as a third fpecies, by the title of purpura urf/i-flnj-, 

 becaufe the eruption commences in the form of rounded 

 and reddiih elevations of the cuticle, refembling the wheals 

 of nettle-ralh ; but they are not accompanied by the fame 

 fenfations, tingling and itching, which belong to the ncttle- 

 rafh. Thefe little tumours gradually dilate ; but within 

 one or two days they iubfide to the level of the furround- 

 ing cuticle, and at the fame time their hue becomes darker 

 and at length livid, or purple. As thefe fpo^s are not per- 

 manent, but appear in fucceflion in different places, they are 

 commonly feen of different hues ; the frelh and elevated 

 ones being of a brighter red, while the level fpots exhibit 

 different degrees of lividity, and become brown as they 

 difappear. They are molt common on the legs, where they 

 are frequently mixed with pctcchis ; but they fometimcs 

 appear on i.ther parts of the body. 



Tlic duration of the purpura urticans is various, from 

 three to five weeks, in the courfe of which time the hands 

 and ankles are affefted with cedematous fwellings : there is 

 alfo a diilreffing degree of languor and debility, and a lofs 

 of appetite, but feldom haemorrhage. It generally appears 

 in fummer and autumn, affefting thofe who are expofed 

 to fatigue, and live on poor diet, and delicate young wo- 

 men of indolent and luxurious habits. The fame precepts, 

 as to treatment, are applicable to this as to the other va- 

 rieties of purpura. 



When purple fpots occur as fymptomatic of bad fevers, 

 they require no peculiar treatment. They are much lefs 

 frequent concomitants of fevers than they were formerly ; 

 a circumftance which is probably to be afcribed partly to 

 the more liberal ufe ot purgatives at prefent in all febrile 

 difeales, and partly to the more free admiffion of frefh air, 

 to the fuperior cleanlineis, &c. now obferved in thefe ma- 

 ladies. The appearance of thefe fpots has been occaiion- 

 ally noticed by various authors in agues, remittent fevers, 

 palfies, dropfy, and atrophy. Dr. Willan obferves, that in 

 the laft ftage of pulmonary confumption they fometimes 

 occur as the immediate forerunners of death. (See Pete- 

 CHi.T,.) For hiftories and cafes of purpura, fee Duncan's 

 Med. Comment, vols. xiv. and xx. and Med. Cafes and Ob- 

 ferv. p. 90. Annals of Medicine, vol. ii. Memoirs of the 

 Med. Society of London, vol. iii. art. 20 ; and vol. iv. 

 art. 17. Medical Trafts and Obf. vol. ii. Willan's Reports 

 on the Dileafes of London. 



PURPURATI, in our Ancient Hiflarians, denote the 

 Ions of emperors and kings. 



PURPURE, PouRPRE, or Purple, in Heraldry, ac- 

 cording to fome, is one of the five colours of armoi-ies, 

 mixed or compounded of gules ;ind azure, bordering on 

 violet ; and, according to others, of a little black and much 

 red colour. It is, by the heralds, fuppofed a fymbol of 

 temperance, liberality, dignity, authority, faith, and piety. 

 Moll; authors in heraldry, as Favyn, Geliot, Monet, and 

 Meneftrier, do not allow purple for a colour, in regard it 

 is not fimple, but compofed of a mixture of other colour?. 

 They rather efteem it a kind of intermediate tinfture, fome- 

 times metal, and fometimes colour : hence the Spaniards 

 call it una mijlion : fo that one cannot lay it on metal and 

 colour without falfifying the arms. 



Add, that many take the purple, as it is accounted, on. 



many ancient bearings, by which fome of the moderns would 



F 2 evince 



