Medicine: Poisons for Purpura

Last week Editor Morris Fishbein, who is particularly interested in purpura, published in his Journal of the American Medical Association two ways of treating that blood disease. The methods were equally inexplicable, equally poisonous. In purpura blood escapes from capillaries and collects under the skin or mucous membranes in spots which range in size from pinpoints to silver dollars, in color from flaming red to black & blue. Bruises cause transient purpuric blotches called ecchymoses. Typhus fever causes dotty purpura or petechiae. The kind of purpura which interested Dr. Fishbein last week was thrombocyto-penic purpura. Victims of this condition are constantly in danger of suffering a gush of blood from any of the orifices of the body. Without apparent cause or warning blood is likely to accumulate in a puddle somewhere under their skin, in the brain, in the adrenal glands. Disease renders capillary walls abnormally permeable to blood by simultaneously thinning the blood and capillary walls. Hemorrhage is due to wholesale escape of blood through the walls of those capillaries. According to one of the articles which Dr. Fishbein published last week, one treatment for thrombocytopenic purpura is the injection of water moccasin venom. The developers of this remedy, Manhattan’s Drs. Samuel M. Peck, Nathan Rosenthal and Lowell A. Erf, advise a long series of hypodermic injections of dilute venom into the loose space between the skin and muscles. They admittedly do not understand the why or wherefore of their treatment. They do know that “it apparently has been of value in 22 of the 34 cases in which it has been used.” Just as inexplicable but more successful were the results which Philadelphia’s Drs. Harry Lowenburg and Theodore M. Ginsburg attained by poisoning two purpuric little boys with parathyroid hormone. That hormone increased the amount of calcium in the children’s blood to such an extent that they vomited persistently, became listless. When the children were on the verge of dying from hypercalcemia. the doctors stopped the parathyroid injections.At once the victims perked up, ceased vomiting—and ceased purpuric bleeding. Last week Drs. Lowenburg and Ginsburg ventured: “A cause and effect relationship between the hypercalcemia and the apparent cures is suggested, although there appear to be no sound theoretical grounds for such a conclusion.”