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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    plugging. On September 19th the purpuric eruption dis- appeared and her general condition was much better, her temperature being normal and her pulse 90 and stronger. On the following day I again removed the tampon from the nostril, but the hemorrhage was so profuse that I at once replugged it, using strips of sterilized gauze saturated with a 20-per-cent, solution of antipyrin. On September 22d I once more removed the tampon and no hemorrhage followed. She made a good recovery and remained ap- parently well until February 5, 1898, when, without pre- monitory symptoms she had a severe chill which was fol- lowed by well pronounced fever and sweating. On February 6th she felt fairly well, but on the follow- ing morning she was agait* stricken with a severe chill, followed by a profuse hemorrhage from the left nostril. I was hastily called and found her in a state of collapse. Her pulse was scarcely perceptible and was weak and thready. The extremities were cold and bathed in a clammy perspiration. I immediately plugged the nostril, both anteriorly and posteriorly, with gauze, but the blood continued to ooze drop by drop. I then removed the tampons and replaced them very carefully with tampons of absorbent cotton,saturated with 1 to 1000 bichlorid-of- mercury solution. The plugs were carried far back into the posterior nares and the whole nostril was very firmly packed. This controlled the hemorrhage, and it was in- deed time, as the patient was rapidly sinking. By the aid of heat and stimulants, hypodermically administered, she gradually revived and when I left her temperature was 99° F. and her pulse 160, very weak and compressible. During the profuse hemorrhage I collected about ten cubic centimeters of blood as it flowed from the nostrils, and fully verified the observations of Hayem, which were afterward confirmed in sixteen cases reported by Beu- 1 Semaine Medicate, June ->o, 1897.