GENERAL DISORDERS OF NUTRITION. 



The indications from the disease itself demand the exhibition of 

 iron. If any medicine ever deserved the name of a specific, iron does, 

 as a remedy in this disease. The surer our diagnosis, so much the more 

 certain may we be of succeeding ; and when, contrary to our expecta- 

 tions, we fail of success, there will be reason for suspecting that the 

 case is not simple chlorosis, but an anaemia depending upon some 

 other unperceived or unrecognizable disorder. The progress of a chlo- 

 rosis, which, developing in a young girl at the period of puberty, has 

 defied all treatment, often proves it to have been but the initiatory 

 stage of a tuberculosis, or the anaemia consequent upon a chronic 

 gastric ulcer. We are ignorant of the manner in which the iron 

 improves the defective state of the blood. The existing red-blood 

 corpuscles are not wanting in iron, but there is a deficiency of the red 

 corpuscles themselves, into whose chemical composition iron enters 

 to a slight extent. Perhaps the iron stimulates the activity of the 

 region where the red corpuscles are formed, or perhaps it regulates 

 the digestion, and thus promotes the supply of material for the forma- 

 tion of blood-corpuscles. But there is no sound foundation for any of 

 these hypotheses, the number of which might be materially increased. 



Opinions vary greatly as to the proper form and dose of iron. Iron- 

 filings are much prized by certain well-known and fortunate practition- 

 ers ; others, equally celebrated and successful, prescribe one or other 

 of its salts, to the exclusion of all the rest, claiming its effects to be 

 more certain, and better borne. Others, again, begin treatment with 

 the " mildest " of the ferruginous preparations, as the mallate or lac* 

 tate of iron, proceeding thence to the " stronger " ones, the chloride 

 and sulphate, winding up the treatment with the filings. Besides the 

 limatura ferri, which may be given in three to six grains as a dose, 

 generally with an addition of powdered cinnamon, the tinct. ferri pomat. 

 (gtt. XV-XXA), the lactate of iron (gr. ij-v), the ferri carb. saccharat. 

 (gr. iv-x), the tinct. ferri chlor. (gtt. x-xxx), ferri sulph. (gr. j-iv), 

 are the preparations of iron in most common use. From the estimate 

 hi which these various* preparations are held by different established 

 authorities, and from the fact that nearly every practitioner has his 

 "pet article," which he uses in the majority of cases, it may be in- 

 ferred : 1. That the efficacy of iron in chlorosis does not depend upon 

 the form in which it is administered. 2. That nearly all ferruginous 

 preparations are well borne in chlorosis. 3. That special indications 

 for the exhibition of one or other of them cannot be laid down. Foi 

 more than twenty years I have used Bland? s pills almost exclusive!} 

 in chlorosis, and have witnessed such brilliant results from them in a 

 large number of cases, that I have never found any opportunity to ex- 

 periment with other articles. Instead of the forty-eight huge boli, 



