An obstinate case of purpura hemorrhagica / by J.H. Burch.

  • Burch, John Holcomb.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: An obstinate case of purpura hemorrhagica / by J.H. Burch. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    plugs not entirely controlling the hemorrhage. I again removed the tampons from the nostrils and the hemor- rhage was very profuse. I repacked both nostrils with absorbent cotton saturated with a solution of acito-tar- trate of aluminium. This controlled the nasal hemor- rhage but a slight oozing of blood continued from the mucous membrane of the gums. Menstruation had ceased and the urine remained the same except that it contained more blood. For the purpose of isolating the bacilli several large test-tubes were carefully sterilized. A catheter was theji employed under strict aseptic precau- tions and about fifty cubic centimeters of urine were thus obtained. The urine was very clear in color, decidedly acid in reaction, and contained one-half of one per cent, of albumin; the specific gravity was 1028. It was then centrifugalized in sterile tubes, the sediment revealing hy- alin and granular casts, also an immense number of red blood-cells, and the peculiar bacillus above mentioned. Immediately after obtaining the urine I inoculated a tube of nutrient gelatin, one of agar-agar, one of potato, and also one of bouillon, all of which were transferred to an incubator, except the gelatin which was transferred to a Petri dish and allowed to develop at room temperature. At the time I also thoroughly sterilized the flexor-bend of the elbow, using the most rigid aseptic precautions, and drew from a distended vein about two cubic centimeters of blood with wnich 1 inoculated a second series of the above-mentioned tubes. The blood-count was as follows; Red cells, 3.200,000 per cubic millimeter; white cells, 14,000 per cubic millimeter; hemoglobin, 35 per cent. The morphological appearances were unchanged. After my experience in piercing the lobe of the ear to obtain blood for examination I employed the finger-tip which gave me no trouble. During the day blood continued to ooze from the mucous membrane of the gums and from