This section is from the book "Materia Medica And Therapeutics Inorganic Substances", by Charles D. F. Phillips. Also available from Amazon: Materia medica and therapeutics.
To ascertain the value (or the reverse) of iron in acute rheumatism, I must refer rather to the experience of others than to my own. Petrequin seems to have been the first to use it, and he reported marked advantage from doses of 40 to 80 min. given in the course of twenty-four hours; he prescribed it with lemonade, and he made trial also of the sulphate and the citrates ("Traite Pratique des Eaux Minerales," These, Paris, 1855, p. 533). Dr. Russell Reynolds -led to use the remedy by consideration of its value in erysipelas- brought before the profession a series of eight cases in which the average duration of high temperature was shortened (to five and a half days as against fifteen), and in several of which pain was quickly relieved and no discomfort produced; but, on the other hand, one patient died comatose, after delirium, and another of pneumonia and pericarditis, while a feeble or intermittent pulse of 56 to 60 caused anxiety in two of the others; it is to be noted that most of these patients had some cardiac inflammation before coming under treatment, yet the results can scarcely be considered favorable (British Medical Journal, ii., 1869). In another series of cases, however, Dr. Reynolds was able to record greater success; thus, out of a total of sixty-five, 44 per cent. of first attacks were convalescent in the course of a week, and most of those suffering from second, third, or fourth attacks, in the second week; one-half of the whole number were severe cases, yet the temperature became normal within fifteen days; hyperpyrexia occurred in three, and proved fatal in two, instances (British Medical Journal, ii., 1872).
If we examine other observations that have been published on this subject, we find satisfactory results obtained by Mr. Bott (British Medical Journal, i., 1870), and the record of six cases successfully treated with perchloride by Dr. Dyce (British Medical Journal, i., 1876); and Dr. Rose finds the remedy "prophylactic of rheumatism" (Lancet, ii., 1871), but, on the other hand, of three cases treated by Dr. Buck, one had urgent dyspnoea, and one unusual cardiac pain (British Medical Journal, i., 1870), and of three cases recorded by Mr. Greene, one died with cardiac lesions, and one had tetanic spasms, so that it seems desirable to ask (with Dr. Trestrail) whether the perchloride given in acute rheumatism may not increase the disordered blood-condition, and the tendency to embolism, and to embarrassed pulmonary circulation: at least, we must say that there is at present much more doubt as to the suitability of this remedy in acute rheumatism than in erysipelas or diphtheria, and it has not commanded the same amount of professional confidence; and yet when the urine is alkaline (as in several of Dr. Reynolds' cases), and the patient is very anaemic and feeble, tincture of steel seems quite appropriate; also rheumatic pain is often relieved by it, and it has decided value in the anaemic condition following acute attacks, and in subacute and chronic varieties of rheumatism. The late esteemed Dr. Anstie drew attention to its power of cutting short subacute cases as observed among the out-patients at the Westminster Hospital; in such as were really rheumatic (and not gouty) in character, with sallow patchy face, deep furring of tongue, oily moisture of skin, obscure aching of limbs, slight rise of temperature, and trouble of respiration, he found that 30 to 40-min. doses, given three to six times in the twenty-four hours, often arrested the progress and relieved the symptoms in a few days; this occurred in seventeen cases out of twenty-nine (Practitioner, September, 1871).