Abstract
The exhibition of purpura as a clinical sign of disease was first ascribed solely to the effects of pestilential fevers. With the demonstration, however, by Denys 1 in 1887 that the purpura of Werlhof is characterized by a lowered level of circulating blood platelets, the clinical purpuric states were definitely shown to consist of thrombocytopenic and nonthrombocytopenic groups. Further differentiation within the thrombocytopenic group has been accomplished slowly since Denys's observations and has depended largely on cumulative experience with known etiologic states in which both purpura and marked thrombocytopenia have been observed to occur. There has thus arisen the practical and important subclassification of thrombocytopenic purpura into two groups—the idiopathic and the symptomatic. This is justified because the successful management of the former often requires life-saving surgery, whereas the latter should be managed strictly by medical means. The reversal of these therapeutic principles may promote disaster to the patient. The
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