It is evident that the first step in the treatment of this disease should be to remove the cause. If the cause is dyspepsia, this must receive attention; if intestinal parasites, they must be dislodged; if prolonged nursing, nursing must be interdicted; if too little food, a larger quantity of nourishing, wholesome food must be employed. The mistake must not be made, however, that by good food is meant what is usually termed rich food or a stimulating diet. Neither should a large quantity of animal food be taken, especially when the digestive organs are impaired, a fact which is seldom observed. In some cases also, particularly those in which there is a degree of fever, rest is an essential for recovery. The patient should be put to bed and required to remain there until he has gotten into a condition in which it is safe for him to exercise. At first, exercise should be exceedingly moderate, being gradually increased. Tonic remedies should be employed. Electricity and massage are among the most useful of all agents. Inunction is another very useful remedy. Sun-baths as a tonic in the treatment of anaemia cannot be extolled too highly. If the patient is able to do so, a large amount of exercise in the open air should be taken daily, when the weather does not prevent. We have frequently attained good results in the employment of Trommers extract of malt in many cases of chronic anaemia. It is a most admirable substitute for cod-liver oil, as has been shown by experiment on a large scale in German hospitals. Dropsy, when present in such a degree as to render special treatment for it necessary, may be best remedied by the use of such diaphoretics as the Turkish or vapor bath. Care must be used, however, in the administration of the bath that the patient be not weakened thereby, and consequently it should not be applied until a considerable degree of strength has been secured.

The popular remedy for anaemia in all its forms is iron, which is administered in a great variety of forms. The theory upon which this practice is based is that the blood corpuscles are deficient on account of the deficient supply of iron, or at any rate that their increase may be augmented by a supply of iron to the system. That this is an error, however, will be readily seen when attention is given to the fact that the food contains a much larger amount of iron than is really needed by the system, as also by the fact to which we have called attention in considering the use of iron in medicine, that it is exceedingly doubtful whether the system can assimilate iron or any other mineral in an inorganic state. It is certain that the partially organized form in which inorganic substances are received as food is much more favorable to their absorption and assimilation than the inorganic state in which they are employed in medicine.

Another fact should be taken into consideration, namely, that when iron is administered as a medicine, an examination of the discharges from the body shows that if any proportion of that taken into the stomach is absorbed, the proportion is exceedingly small, nearly the whole being expelled with the bowel discharges, as elsewhere remarked. It is very probable indeed that the favorable results apparently obtained from the use of iron are really the effects of the other remedies employed or of the improved hygienic conditions of the patient. We are certain at least of having cured or helped to recover some cases of anaemia without having found it necessary to resort to the use of iron, and never have seen any benefit whatever from its use in the few cases in which we have employed it experimentally.

Although this doctrine may be considered by many very heretical, we are glad to know that we are not alone in the profession in our skepticism as to the value of iron as a therapeutic agent, as we have shown in the previous part of this work.

An exceedingly fatal, but fortunately rare, form of this disease, known as progressive anaemia, has been observed during the last few years. It is particularly apt to occur during pregnancy, and especially in women who have borne several children in rapid succession. In genuine cases of this disease it is stated by the few physicians who have observed them that no remedies thus far employed have been of any value. The patients steadily decline from the first in spite of all that can be done for their relief, the fatal termination being reached in from six or eight weeks to some months.