The remarkable and serious malady now known under this name, and which was first described by Dr. Addison as "idiopathic anaemia," has proved sometimes amenable to arsenic. It occurs often, without appreciable cause, about or beyond middle age, the patient becoming blanched and waxy-looking, sometimes jaundiced, and suffering later from oedema, dyspnoea, giddiness, and coldness. The blood is found to be dull-red in color, and the red corpuscles to be diminished and altered; retinal and other hemorrhage may occur, also occasional attacks of vomiting and diarrhoea. The patient remains, or becomes, fat rather than emaciated, yet the disease has usually ended fatally by exhaustion and collapse in spite of iron and food, etc. Dr. Bramwell has recently recorded a typical case, which was carefully treated in hospital for three weeks with full doses of quinine and iron, and later phosphorized cod-liver oil, and yet steadily got worse until 2 min. of liquor arsenicalis were given thrice daily, the other remedies being stopped. The dose was gradually increased to 16 min. thrice daily, and "the after-progress of the case may be described as one of slow but uninterrupted improvement." In a month's time he was able to attend as an out-patient, and continuing to take arsenic considered himself well, and resumed work. His color improved, cardiac murmurs disappeared, and the condition of the blood was found to be normal (Medical Times, ii., 1877). Such a case, in conjunction with others, offers much encouragement in the use of the remedy, and serves to illustrate further its alliance with phosphorus, which drug has also proved useful in some similar cases (v. p. 55).

Dr. Lockie has lately published illustrations of the value of arsenic as a "blood and cardiac tonic in anaemia" (British Medical Journal, ii., 1878). Dr. M. Finney has recently reported three well-marked cases of "pernicious anaemia," two of which recovered under arsenic, and he calls it "one of our surest tonics to the blood-making organs" (British Medical Journal, i., 1880). Dr. Withers Moore informs me that in a similar case (idiopathic anaemia), under his care at the Sussex County Hospital, arsenic also proved of service. The patient, a woman, aged thirty-two, showed characteristic symptoms of the malady nine months after a bad confinement, and after frequent epistaxis: she was extremely pale and feeble; the red corpuscles of the blood were few, small, and altered in shape, the white corpuscles not increased in number. For the first three months of her stay in hospital iron was tried in various forms without any benefit whatever; for the last two months she got 3 min. of Fowler's solution thrice daily, and ultimately left convalescent. The case was a typical and severe one, with occasional pyrexial attacks, raising the temperature to 104° F., and even, on one occasion, to 106° F. These attacks were controlled by full doses of quinine, but excepting this arsenic was the only medicinal agent used during the stage of recovery.