Case of fatal purpura associated with waxy degeneration of the striated muscles, and also of the vessels in the affected parts / by Wilson Fox, M.D.

  • Fox, Wilson, 1831-1887.
Date:
[1865], [©1865]
Catalogue details

Licence: Public Domain Mark

Credit: Case of fatal purpura associated with waxy degeneration of the striated muscles, and also of the vessels in the affected parts / by Wilson Fox, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    4/12 (page 4)
    eruption on face. No fresh patches have appeared, and there is no marked extension of any previously noted. Swelling noticed on right hand has disappeared, and there is now no discoloration in this situation. Prostration increased ; manner excited ; pulse 136, small, weak, jerking. Spots on palate are less marked than before. Those on back have decidedly faded. Skin moist and perspiring. There are some spots of vesicular eruption near scapulae; skin around is neither in- durated nor purpuric, and only slightly inflamed. Fine crepitation still heard at left base. Dulness at right base has disappeared. There is now a blowing murmur with first sound of heart, most dis- tinctly at apex. The comparative number of white blood-cells in a drop of blood drawn from finger is decidedly diminished ; but many of them are very granular, and some are seen distinctly disinte- grating, and some granular debris is seen in the field corresponding in all essential characters to the granules seen in the cells. This cha- racter was again tested with one of Powell and Lealand’s x 1250 diameter, and the observation was found to be confirmed. There was no distinct outline to a great number of the white corpuscles, but in others this was very distinctly present, and they were iu many cases becoming granular and breaking down. The nuclei appeared to be unaffected by the granular change. Is this a physiological or pathological condition (?). The red corpuscles were entirely unaffected. Urine acid ; no albumen. Not a trace of blood. Sp. gr. 1013. 22nd.—Ordered, brandy gvj. in addition to claret; three eggs. 23rd.—Prostration greatly increased. Great restlessness and jactitation. No more purpuric spots. Dulness and physical signs in lungs unchanged. Brandy, xg. Died at 3 a.m. on 24th. For the following table of the temperatures of the patient I am indebted to Mr. B. H. Allen, Physician’s Assistant : 10 A.M. 10 P.M. 17 — loot 18 loot loot 19 100 10D 20 101f 102t 21 101f 22 102 102f 23 1011 Post-mortem twelve hours ufter death.—Rigor mortis well marked in all the extremities ; purpuric marks in skin somewhat faded, but very like those observed during life. Body opened.—Amount of subcutaneous fat moderate. There are some small petechial spots on parietal peritoneum aud on upper surface of the rectus muscle on right side, but this muscle presents no deviation from the ordinary colour and appearance. On left side there are numerous petechiae on parietal surface of rectus, and in many spots this muscle presents the following peculiar appearances : Patches of the muscle from one quarter to half an inch in diameter are of a wliitish-grey, with none of the usual appearance of muscle, and con-