HOUSE PHYSICIAN, RIhDICAL UNIT, BT. BARTHOLONEW'S HOSPITAL.Trm operation of splenectonip in the treatment of purpura hzniorrhagica was performed for t h e first time in 1916 by K a~n e l s o n ,~~ who argued t h a t the h;emorrhages were the result of the constant reduction in the number of blood platelets, or thrombocytes, and that this reduction was brought about by the destructive action of a diseascd spleen. He suggested the name ' thrornbocytolytic purpura '. Frank26 also advised splenectomy, but on different grounds-namely, t h a t the reduction in platelets was due to an inhibitory action of the spleen on the bonc-marrow, and for this reason called the disease 'essential thrombopcnia'. As pointed out by K~s t e r ,~~ experimental evidcncc favours Kaznclson's view : " 'iYere the platelets not formed in sufficicnt numbers, the amount of thromboplastic substance furnished t o the blood by their destruction would be insufficicnt t o cause prompt coagulation. Thc coagulation time, however, in this disease remains normal ".Following in the wakc of Frank and Kaznelson, many observers have. performed splenectomy in the treatment of purpura hzemorrhagica, and have reported good results accruing therefrom. It is thought advisable, thercfore, t o report the following two cases in which splenectomy was performed : tlie one, in which there was no recurrence of hzemorrhages a€ter a period of eight m o n t h ; the other, in which splenectomy had no effect on their occurrcnce.