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Arch Intern Med (Chic). 1923;32(6):939-953. doi:10.1001/archinte.1923.00110240132008.
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The rôle of the blood platelets in hemophilia and purpura hemorrhagica, which comprise the hemorrhagic diseases, is of paramount importance. Hemophilia is the result of some qualitative change in the blood platelets (Fonio,1 Minot and Lee2) resulting in defective coagulation of the blood. Purpura hemorrhagica is accompanied by a qualitative change and by a greatly diminished number of blood platelets; also by some change in the capillary activity resulting in a hemorrhagic tendency. This constant diminution of the platelets without any known cause (Denys,3 Hayem4) has given rise to the better modern name of essential thrombopenia (Frank5) or better still, thrombocytopenia (Eppinger6). Essential thrombocytopenia is a distinct clinical entity and is characterized by the following main features:

1. Diminution of the blood platelets. The average number of blood platelets in normal blood is 250,000. The platelets vary from none to 100,000 in this disease; at times the number may reach the


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