Treatment

Piffard says that one drug stands prominent and alone as an efficient agent in the treatment of purpura, and this is ergot. He advises the use hypodermically of ergotine, or drachm doses of the fluid extract given internally two or three times a day. He also advises against the use of iron, quinine, and similar drugs of the tonic class.

The diet should consist of the most nutritious articles. Malt preparations are useful foods. Outdoor exercise is very beneficial. Locally, hamamelis is one of the best remedies, and when there is much haemorrhage, ice treatment may be resorted to.

Simple purpura responds bestto Ars. alb., and the haemorrhagic form to Sulph. acid. Other remedies may be indicated as follows.

Arnica. - Yellow, blue and reddish-blue spots; in lying-in women.
Baptisia. - Livid spots all over the body and limbs, of the size of a three-cent piece; great languor; desire to lie down; tired, bruised, sick feeling all over the body.
Berberis. - Petechiae on the right shoulder or left humerus, back of the head and wrist. Bruised pain with stiffness and lameness in small of back; renal or vesical complications.


Chloral. - Its continued use internally has caused purpura haemorrhagica, preceded by a bright red bluish, ery-thematous in aspect, but permanent under pressure, followed in two days by deep red spots, mixed with mottled livid patches. The buccal mucous membrane becomes red, raw, ulcerated, and blistered, breath fetid, pulse 120 and feeble. A desquamation ensued, but with bed-sores in some places. In other cases it caused petechiae, vibices, and ecchymoses.
Coca. - Dark spots like ecchymoses under the skin, about the size of a pin's head, on the fingers.
Erigeron. - When apparently well-indicated remedies fail.
Hamamelis. - Haemorrhagic purpura; profuse epistaxis; passive, venous haemorrhages; great lassitude and weariness; in old people.
Lachesis. - Simple purpura; blackish-blue spots; great physical and mental exhaustion; climacteric troubles.
Mercurius. - Bluish-red spots, darker on the margin and lighter in the centre. Other symptoms of Merc, present.Phosphorus. - Petechial spots on the skin; bluish-red spots on the legs; purple-like exanthem over the whole body.
Rhus tox. - Simple purpura; dark brown spots on inside of ankles; rheumatism of joints worse during rest- swollen ankles after sitting too long.
Terebinth. - Haemorrhagic purpura; intestinal haemorrhages; hematuria.
Verat. vir. - Simple purpura; galvanic-like shocks in the limbs; rapid pulse; slow respiration; in plethoric individuals.