Selected monographs on dermatology / P.G. Unna [and others].

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs on dermatology / P.G. Unna [and others]. Source: Wellcome Collection.

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    the fourth, and one the fifth day. Before he had completed this course, an eruption of purpuric spots appeared on the body, more abundantly distributed on the lower extremities. They disappeared in the course of ten or twelve days after discontinuance of the medicine. Wigglesworth observed an eruption of non-elevated, irregularly circular patches situated upon the forearms and ankles. They were attended with burning and itching, and were painful on pressure. The spots appeared one hour after taking a one-grain pill of quiniue, and, under the continued use of the pills, until twelve were taken, the lesions increased in size and number, and became well-marked hasmorrhagic patches. Vepan, cited by Jeudi di Grissac, reports four cases in which an eruption of petechial spots occurred over the whole body from the use of comparatively small doses of quinine. In a case of a lady who took first o-i and later 0*15 gram, the eruption increased in violence and extent with the increase of the dose. In this case the purpura was accompanied with bleeding from the gums and sanguinolent stools. Gauchet reports a case in which the intolerance of quinine was so absolute that small doses, only ten centigrammes con- tinued for four days, produced purpura with buccal haemor- rhage, principally from the gums. The petechial spots were abundant and generally distributed. In this case Gauchet gave quinine in opposition to the wishes of the patient, who stated that she had taken it before and that it always caused her to spit blood.1 The hullous form.—This form is comparatively rare, but the possibility of its occurrence is well authenticated. M. Panas, cited by Bergeron and Prost, affirms that the admin- istration of large doses of quinine (two or three grams, as is the custom in Algiers and Greece) provoked an eruption resembling the bulhe of pemphigus. Fowler reports a case in which four grains of bisulphate of quinine produced an eruption of bright-red patches, varying 1 Kobner records a case of haemorrhages into the skin and from the bowel which recurred after the subcutaneous injection of quinine in a child. He refers to other instances of tympanic and intestinal haemorrhage following the use of quinine. Hsematuria, epistaxis, and bleeding from the tonsils have also been recorded on several occasions.—T. C. F.