17970] 
as the petechiz in malignant fevers ; and 
with regard to fize, colour, é&c. very 
much refemble flea-bites, only being 
without the ceritral point made by the 
fting of the infect. On the legs, how- 
ever, they are ufually formewhat larger, 
and often become confluent in irregular 
patches. .The only diforder attending 
the eruption, is a fenfacion of general 
weakneis and languor, without any fe~ 
brile fymptoms; and a cure is readily 
performed by the application of proper 
diet, and a fuficient degree of exercife. 
Another form of the difeafe, which may 
be entitled purpura bemorrbagica is much 
more violent and dangerous. For fome 
weeks previous to the appearance of 
purple fpots, the ‘patient complains of 
an oppreilive fenfation of languor, weari- 
nefs, faintnefs, and a gnawing pain at 
the ftomach. Sometimes the eruption is 
more immediately preceded by fhiverings, 
naufea, bilicus vomitings, andacute pains 
of the limbs, referred to the bones. The 
{pots appear firft on the legs, and after- 
wards, without any certain order, on the 
thighs, arms, and trunk of the body. 
Their primary colour isa bright red, but 
this, within a day or two, changes 
toa purple or livid hue. They are con- 
fiderably larger than the fpots of the pur- 
pura fimplex, but, like them, are “always 
nearly of a circular form. Sometimes 
they are few, and diftiné& ; fometimes 
numerous, and coherent; they are fome- 
times diltributed uniformly over the 
furface of the body, fometimes in irrega- 
Jar clufters. In many cafes, they are in- 
terfperfed with vibices, or livid patches, 
refembling the effects of a bruife. 
The hzemorrhagy which always at- 
tends this kind of eruption, is at frit 
very protufe, and, however it may be 
checked, returns frequently; in fome 
inttances, every day, at a ftated hour’; it 
takes places from the noftrils, throat, and 
mouth; often from the lungs, ftomach, 
or inteftines ; alfo from the uterus, even 
at an advanced period of life. A foftnefs 
and {welling of the gums is not a conftant 
appearance in the hemorrhagic purpura ; 
when blood is difcharged from the 
mouth, it feems to fpring from abrafions 
on the infide of the cheeks, on ‘the 
tongue, or tonfils; all which furfaces 
are occafionally covered with purple 
{pots. 2 
This difeafe has, no regular or ftated 
termination; it has been protracted in 
the different cafes which I have feen, 
from three weeks to twelve months and 
@pwards. In none of thofe cafes did 
» Account of Difeafes in Londm. 
391 
the difeafe prove fatal: it appears, how- 
ever, from the accounts of medical au- 
thors, that the hemorrhagy has, on fome 
occahons, been {fo violent as to produce 
almoft immediate death*. When the 
difeafe has continued fome lenoth of 
time, anafarcous {wellings, and gan= 
grenous ulcers of the extremities, 
ufually fucceed. 
The exciting caufes of the hemor- 
rhagic purpura, feem to be poor diet, 
a fedentary mode of life, watching, and 
anxiety of mind. Hence, it affects 
women in a much larger proportion than 
men. ‘The complaint, however, is, in 
this place, very frequent among children 
who live well, and are under no parti- 
cular reftraint. Infuch cafes, I appre- 
hend, it muft be referred to the impure 
air of a large city, andtothe want of the 
falubrions exhalations from growing 
vegetables. Asa proof of this pofition 
it may’ be mentioned, that children 
affected with the difeafe, on whom the 
ufual remedies have been applied with 
little fuccefs, are prefently cured, after 
being removed into the country. © 
‘The mode of treatment for this~ dif- 
eafe, is fimple, and may be comprifed in 
a very few words ; it is proper to recom- 
mend a generous diet, the ufe of wine, 
Peruvian bark, and. acids, along with 
moderate exercife in the open air, and 
whatever may tend to produce cheer- 
fulnefs, or ferenity of mind. 
Cafes of the purpura, or petechia fine 
febre have, of late, been multiplied, ‘in 
periodical publications relating to medi- 
cine, as if the difeafe were new, or extra- 
ordinary. It muft, undoubtedly, be confi- 
dered as a branch of the true ‘curvy, and 
as fuch it has been properly noticed by 
the writers on that fubjeét, two hundred 
years ago. It was not unknown to the 
ancients, for Hippoérates himfelf has de- 
{cribed the eruption, and mentioned fome 
of the circumftances which ufually at- 
tend it; fee his Prenot. Coac.’ feG.2. 
Actuarius has alfo fhown his acquaint- 
ance with this difeafe, and theorizes 
upon it, according to the notions of his 
own time: De Meth. Med. lib. i. 
cap. 23. 
Cafes of the purpura are related by 
Amatus Lufitanus*, Eugalenus+, Hor- 

* See the cafes in the A&ta Natur. Curiofor. 
& Lifteri Exercitat. de Scorbuto. 
+ De morbo Pulicari fine febre ; Curat. Med. 
70. Cent. 3, anno 1550. 
f De Scorbuto,’ fee obf, 2. 33. 59.62. 68 © 
69. 72. . 
Eg ftius, 
