A FATAL CASE OF PURPURA

HEMOR-

RHAGICA IN A CHILD. By Surgk.-Capt. G. H.

was

Hospital on gic purpura. Previous

i.m.s.

years, iNative

MONIKAj

female,

FINK,

Christian aged 10 admitted into the Bijnor Dufferin the 2nd March 1892 for hemorrhahad suffered from delicate child.

history.?She

malarial fever and

was a

Family history?None obtainable. Past state of health.?Indifferent; had

ered

lately

suff-

from fever.

Present illness.? On the 1st March 1892 she attended the mission school, but was obliged to

leave her class very suddenly feeling ill. On the 2nd March profuse epistaxis with vomiting and hsematemesis came on, and she became unconscious soon after. Small petechia next began to appear on her lips and various portions of her body. When I saw the patient she was uucou-

June

APHONIA.

1892.]

scious;

could not

her eyes

speak

or

recognise anybody

;

turned upwards; her breathing hurried and inclined to be stertorous in character, body cold, legs drawn up, and purple petechial spots present 011 the lips, chest, abdomen,and limbs; slight epistaxis present with vomiting and haematemesis. The female hospital assistant had were

already prescribed tincture of perchloride and ergot to check haemorrhage, but it

of iron did not prove very effectual. I then ordered gallic acid in full doses with ferri et quinine citratis gr. iii and stimulant mixture 5U every fourth hour. Diet., milk ad libitum. The epistaxis and haematemesis with vomiting was checked by the evening, but there was 110 change for the better in her general condition ; in fact she seemed to be losing ground rapidly. 3rd March.?Worse; slight epistaxis and vomiting have reappeared ; treatment continued ; nutrient enemata ordered. 4th March.?Sinking rapidly ; the purpuric spots have increased in number, size and depth of colour ; treatment continued as before. 5th March.?Patient's condition is very grave; sank into a deep coma and died at 3 p. M. Purpuric spots largely increased in size and distribution all over the body.

177

A Fatal Case of Purpura Hæmorrhagica in a Child.

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