The Purple Heart is awarded each time someone within the Imperial Military is wounded or killed in combat, or an Empire ally fighting for The Empire's cause. Due to the fact that in Runescape you can respawn after your killed the Purple Heart is one of the few awards that Emperor Hester is authorizing many number awards to be created.
Displaying the Purple Heart
There are three ways to display the Purple Heart:
The ribbon form is the only accepted form of wearing the Purple Heart in The Empire's Forums, outside of the forums are optional, including email other forums etc.
The Medallion represents five (5) purple hearts one has received, rather than display twenty purple hearts one would only show four medallions. Should one gain seven Purple Hearts they'd display one medallion and two medals.
The Medal it's self is given one per battle injured or killed in combat.