File:The diseases of infancy and childhood - designed for the use of students and practitioners of medicine (1918) (14597763567).jpg

Identifier: 39002086411023.med.yale.edu
Title: The diseases of infancy and childhood : designed for the use of students and practitioners of medicine
Year: 1918 (1910s)
Authors: Koplik, Henry,1858-1927
Subjects: Children Pediatrics
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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ing at intervalsof days or weeks. In other cases there are edema of the face andenlargement of the spleen. In one of my cases there were at firstslight hemorrhages from the bowel. There may be epigastric painand tenderness in the course of the disease. The average duration of the affection is from ten to fourteen days.There may be relapses extending over weeks. Prognosis.—The prognosis is good even when there are severalrelapses and when the affection takes a subacute course. Treatment.—Rest in bed is the first requisite of treatment. Thepatient is put on a nutritious diet in which there is an abundantallowance of fruit and vegetable acids. Lemonade and orange juiceare especially indicated. The bowels are regulated and the salicylateof sodium is given in moderate doses. A child four years of age isgiven grains iv (0.3) three times daily. The pains in the jointsare easily controlled by rest. In the subacute stage small doses ofFowlers solution are of great benefit. > X h<-Ja,
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3 a o 0 X DISEASES OF THE BLOOD 739 Henochs Purpura.—Henoch in 1874 described a series of 4 casesof purpura which he classified as distinct from purpura hemorrhagicaor pehosis rheumatica. The s^^nptoms were as follows: Childrenin apparent good health were attacked by a form of purpura in whichthere were arthritic pain, vomiting, and intense abdominal painwith bloody diarrhea. The rheumatoid pains were accompanied byswelling of the joints. The purpura was of the hemorrhagic type—that is to say, there were extravasations of blood in the form of ecchy-moses or raised exanthematic areas, not disappearing on pressure.The areas were situated on the abdomen and lower extremities Thejoints affected were those of the wrist, elbow, and ankle. The intes-tinal sjTnptoms consisted of repeated vomiting, tjonpanites, excru-ciating colicky pains, bloody stools, and tenesmus. One case wasfatal. Such cases have been from time to time described by otherobservers. I have seen a number of cases. These

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