GENERAL DISORDERS OF NUTRITION. 



preparations which can be tolerated in the largest doses, and of these 

 Bland? s pills stand highest on the list. 



A very common error in the treatment of this affection consists in 

 the attempt to relieve the erethism, digestive disturbance, and other 

 troubles due to the state of the blood, by means of mineral acids, bit- 

 ters, and other medicines ; while iron, from which alone, or at least 

 from which the greatest benefit is to be anticipated, is neglected. 

 Such preparatory treatment almost always retards the recovery un- 

 necessarily. 



I will finally observe that, as long as my chlorotic patients continue 

 languid, indisposed to exertion, and void of appetite, I do not urge 

 them to walk or to eat, generally to their great satisfaction ; but I 

 make them promise that they will exercise assiduously as soon as they 

 feel the strength and inclination to walk, and that they will take food 

 freely whenever they gain an appetite to eat, the acquirement of which 

 is seldom long withheld. I have already said that relapses of chlorosis 

 cannot be averted, especially when it sets in at the commencement of 

 the period of evolution ; hence I always take the precaution of suggest- 

 ing the possibility or even the probability of a relapse, and have often 

 found that the patient and her relatives do not take the prospect much 

 to heart, when I assure them that the second attack will be as speedily 

 curable as the first. 



Although, as I have said, I consider the chalybeate springs super- 

 fluous, and far less effective than iron given in large doses, yet, when 

 a convalescent from chlorosis fears a relapse, I would recommend the 

 springs of Pyrmont, Driburg, Cudowa, Altwasser, St. Moritz, in Swit- 

 zerland, and Imnau, in Swabia. 



CHAPTER II. 



SCOBBUTUS SCUKVY. 



ETIOLOGY. The abnormal changes in the quality of the blood tt 

 which chlorosis is due can be detected by microscopic and chemical in 

 vestigation ; these aids fail us in our researches upon scurvy. It has 

 been stated, indeed, that, in scorbutic blood, the fibrin is diminished, 

 or has lost its coagulability ; or that the salts of soda are abnormally 

 increased, while those of potash are diminished ; but, after repeated in- 

 vestigation, the truth of none of these statements has been established. 

 Nevertheless, the commonly adopted opinion, that scurvy is a disease 

 dependent upon a derangement in the composition of the blood, is 

 probably correct. Independently of the fact that the disease arises 

 under conditions unfavorable to a normal composition of the blood, we 



