President's Address: Purpura of the Urinary Tract

Twenty-four cases of purpura of the urinary tract are discussed and analysed.Purpura of the kidney may be a cause of painless haematuria. In some cases nephrectomy may be necessary to check the bleeding.Purpura of the bladder is a cause of painful haematuria. In such cases the diagnosis can be made with the cytoscope.A number of the cases appear to be caused by a streptococcal infection of throat, teeth or bowel.The exhibition of horse serum by the mouth usually has an immediate effect in checking the bleeding tendencySplenectomy should be considered in severe chronic recurrent cases.Purpura is a symptom and not a disease. It can attack the kidney or bladder in any type of case. The attacks may be simple, recurrent or fulminating. In many cases no cause can be discovered, in others it is associated with acute rheumatism. In a number of cases a proximate cause can be discovered, in the nature of a bacterial infection, a chemical poison, a thrombocytopenia, splenomegaly, or the deprivation of some vitamin.