A Practical Treatise On Diseases of the Skin

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233 The hemorrhage being profuse, or continuing unchecked by- treatment, is always an unfavorable sign, and until it ceases completely, and fresh spots no longer appear on the cutaneous, or mucous surfaces, the patient cannot be re- garded as safe. Bleeding from the gums, particularly when at all excessive, is, in my experience, one of the gravest symptoms of the disease, even although there may be but little eruption on the integuments ; I have rarely seen a case of purpura recover in which it... was present to any extent.
Occurring in the young, the strong, and the robust, and in the old, the weak, and the feeble, it is difficult to arrive at any correct view of the pathology of purpura. The precise condition of the circulatory apparatus, and of the blood itself, in which that fluid escapes from the vessels most remote from the centre, has not been sufficiently investigated as yet, to enable correct deductions to be drawn as to the real nature of the disease. It is true, that the blood in purpura has been chemically analyzed and microscopically examined, but the results affi3rd no further information than what had been previously gained by the unaided senses — that it is deficient in solid constituents, in consequence of which it is in most cases extremely fluid, and does not coagulate after its exudation through the mucous membranes, or should it be drawn from a vein; yet, as shown by the analysis of Frick, of Garrod, and of Parkes, the fibrine may be in excess, and the property of coagulation not deficient in purpuric blood.


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