342 CHLOROSIS 



been added remedies which contain hemoglobin itself in different combina- 

 tions. 



All of the last-named remedies are based upon the hypothesis that iron is 

 absorbed and assimilated more readily when combined with albumin products^ 

 especially those prepared from blood itself in accordance with modern organo- 

 therapy ; these give to the organism as directly as possible a compensation for 

 the loss of hemoglobin in the pathologically altered blood. 



Of the organic iron preparations there are to be named ferratin, an arti- 

 ficially produced iron preparation (Schmiedeberg), which is said to be iden- 

 tical with the iron combinations present in the organism and in the food; 

 further, ferrum peptonatum and the various liquores ferri albuminati. Of 

 iron-containing blood preparations new ones are combined and placed upon the 

 market almost daily, so that it is scarcely worth while to mention the names 

 of these, for the most part, ephemeral preparations. Especially fashionable 

 in practice are hematogen, hemaldumin, hemol, sanguinal, etc. It must be 

 remembered in the employment of all these remedies that in all probability 

 the iron, whether given in an organic or inorganic combination, is primarily 

 attacked by the gastric juice and changed into a chlorid combination, and that 

 later it is absorbed in the bowel as an iron chlorid albuminate. It is therefore 

 quite unlikely that the artificial or natural iron albuminates are absorbed in 

 the form in which they are administered, and it may be assumed that, during 

 the time of their absorption into the fluids of the body, great labor is thrown 

 upon the stomach and intestine, much greater than in the administration of 

 inorganic preparations. 



Kegarding the special activity of these remedies in chlorosis, neither from 

 literature nor from my own experience are many observations of patients of 

 this sort known to me, from which it might be concluded with any certainty 

 that any one of the above-mentioned organic preparations produces a cure 

 more rapidly and with greater certainty than is observed upon the administra- 

 tion of the ordinary iron preparations. 



What is particularly lauded by the manufacturers concerning these reme- 

 dies is the useful action of the albumin contained in them; but it must be 

 mentioned that these amounts of albumin are so small that they play- no role 

 in the nutrition of the chlorotic, particularly as in this disease there is no 

 noteworthy deficiency in albumin metabolism. 



Unquestionably the majority of these -modern remedies act by suggestion, 

 and therefore in practice we can rarely do without them, as the laity nowadays 

 manifest the greatest interest in the products of pharmaceutical industry. In 

 cases, however, in which the therapy remains uninfluenced by these subjective 

 effects upon the patient, as in hospital treatment, there is absolutely no reason 

 for rejecting the old well-tried iron preparations in their various combinations ; 

 thus, for example, the excellent Blaud's pills. 



According to the suggestion of C. Gerhardt, for some years I employed 

 with success liquor ferri sesquichlorati, three to five drops three times daily, 

 diluted in water. 



The numerous iron springs in Germany and neighboring countries contain 

 iron for the most part as a suboxid combined with carbonic acid, and the 



