1. In excessive anaemia, whether from haemorrhage or any other cause, the stronger Salts of Iron, the Sulphate or Perchloride, are chiefly indicated. In ordinary debility, the milder salts, the Ammonio-Citrate, or the Potassio-Tartrate, are to be preferred. In scrofulous subjects the Iodide is an eligible form.
2. Any gastric irritation which arises from their use, may be obviated by the addition of Ext. Hyoscyami, or Conium. If one salt should disagree, a milder one may be substituted.
3. Acids, and acidulous fruits, should be avoided during their use, as, by combining with them in the stomach, other compounds may be formed, which may either give rise to irritation, or render the remedy less active.
* Animal Chemistry, trans. by Dr. Day, vol. i. p. 310. Bull. de l'Acad. de Med., Jan. 31,
Year-Book, Sydenham Soc., 1862, p. 115.
4. The faeces, under the use of this medicine, are black and offensive; this should be remembered, otherwise it might lead to the supposition that the biliary action was greatly vitiated. On discontinuing the medicine, the stools resume their natural colour. The tongue also, if Iron has been taken in solution, becomes black.
5. During a prolonged course of Iron, the medicine should be intermitted for a short time, every ten or fifteen days, in order to ascertain the real state of the alvine secretions.
Besides correcting the costiveness, which it is the tendency of ferruginous salts to induce, they act by removing the serosity of the blood in "watery stools;" and thus, the proportion of serosity, and that of the organic elements, including the HAematin, in the blood, are rendered more equal.
7. In anAemic states, the Salts of Iron are productive of the best effects, up to a certain point; that is, until the blood contains its normal amount of Iron; if continued beyond this point, the blood, becoming surcharged with HAematin and Globulin, a state of plethora is induced, and indigestion and general derangement results, as a natural consequence.
8. In order to judge fairly of the effects of Iron, it requires to be persevered in for several weeks, and to be given in full doses.
Iron is contra-indicated - 1, in all inflammatory affections; 2, in congestions; 3, in plethora, or plethoric states of the system; 4, in the sanguine temperament generally.
Iron-wire sutures, as a radical cure for Hydrocele, have been proposed by Prof. Simpson.* The practice is founded upon the fact that Iron and other metallic wires, when placed in contact with living tissues, do not as a general law excite inflammation to a higher stage than that of adhesion or the effusion of coagulable lymph. Two cases successfully treated by this means are recorded by Dr. J. Young. The number of fine metallic wires, or setons, passed through the sac, was four in one instance, and five in the other. Sutures of iron-wire have also of late years been much employed in various surgical operations.