534  Pharmacologic  Superstitions.  {^Jo^Humj. 
ease.  The  fact  that  the  popular  names  of  the  drug  and  of  the 
disease  begin  with  the  same  letter  of  the  alphabet  seems,  to  a  certain 
type  of  mind,  final  proof  that  they  were  meant  to  go  together. 
Some  years  ago,  at  the  time  when  it  was  believed  that  astringents 
might  be  absorbed  into  the  blood,  ferric  chloride  was  recommended 
for  the  purpose  of  diminishing  the  quantity  of  albumin  in  cases  of 
parenchymatous  nephritis.  According  to  present  pharmacologic 
and  pathologic  theories,  however,  this  seems  neither  possible  nor 
desirable. 
It  is  generally  held  today  that  the  action  of  astringents  is  due  to 
coagulation  of  the  bodily  proteins.  If  this  view  is  correct,  it  is 
evident  that  no  astringent  can  exist  in  the  blood,  for  it  would  at  once 
precipitate  the  blood  serum,  and  a  fatal  thrombosis  or  embolism 
would  occur.  As  we  are  entirely  ignorant  concerning  the  mech- 
anism of  albuminuria,  it  is  impossible  to  theorize  as  to  whether,  if 
an  astringent  could  reach  the  kidney,  it  would  diminish  the  amount 
of  albumin  in  the  urine.  There  is  not,  however,  the  slightest  reason 
to  suppose  that  to  diminish  the  albumin  by  any  such  mechanical 
means  would  be  of  the  least  benefit  to  the  patient.  To  hide  the 
rottenness  of  a  beam  with  a  coat  of  paint  does  not  strengthen  the 
building,  nor  does  the  prevention  of  the  excretion  of  albumin  lessen 
the  inflammatory  process  in  the  kidney.  There  are  symptoms  whose 
relief  is  desirable,  although  Ave  know  that  in  relieving  them  we  do 
not  affect  the  progress  of  the  disease ;  but  albuminuria  can  hardly 
be  classed  as  such  a  symptom. 
I  do  not  wish  to  be  understood  as  attempting  to  deny  the  value 
of  iron  in  certain  cases  of  nephritis.  There  is  no  room  for  doubt 
that  when  Bright's  disease  is  complicated  with  anemia,  as  it  so 
often  is,  the  use  of  this  drug  is  beneficial.  This,  however,  is  some- 
what beside  the  question ;  my  main  contention  is  that  iron  in  no  form 
exercises  any  specific  effect  on  the  kidney.  It  is  indisputable  that 
when  the  renal  condition  is  complicated  by  anemia,  iron,  because  of 
its  hematinic  effect,  may  be  useful ;  but  there  is  no  ground  for  the 
superstition  that  Basham's  mixture  exercises  a  special  influence. 
Nevertheless  Tyson19  is  forced  to  remark,  "  It  is  prescribed  con- 
stantly in  the  most  reckless  and  thoughtless  manner." 
Dr.  Basham,  who  seems  to  have  originated  the  mixture  of  am- 
monium acetate  with  ferric  chloride  which  goes  by  his  name,  was  no 
believer  in  the  antiquated  astringent  hypothesis  or  yet  in  the  specific 
19  Tyson :  Practice  of  Medicine,  1900. 
