Iron-spray—a weak solution of the liquor ferri subsul-phatis ( 3 j— oz viij)—is very serviceable as an astringent in obstinate cases of epistaxis. The nozzle of the delivery-tube of the spray-douche should be inserted just within the anterior nares, and the spray be driven with considerable force. The same application is beneficial in chronic coryza, but the objection to its use is the danger of coloring the teeth. In pulmonary haemorrhage, the same application made to enter the throat with the inspired air will often arrest the flow of blood; and this, notwithstanding so little iron can pass the chink of the glottis.

The subsulphate and pernitrate solutions are the most efficient remedies for arresting haematemesis. They should be given in small doses—one or two drops, well diluted with ice-water, and frequently. In the absence of these, the tincture of the chloride may be used in the same way. In intestinal haemorrhage the astringent preparations of iron are much less beneficial, if, indeed, they serve any useful purpose —for they are converted into inert sulphides as they descend the canal

The author has seen the intestinal haemorrhage of typhoid fever much increased by the rectal injection of a solution of Monsel's salt. The bleeding from haemorrhoids may be much diminished and even arrested by washing the tumors, when they protrude, with the solution of the subsulphate. After the application of the iron, the tumors should be well oiled before returning them into the rectum. The solution of the pernitrate of iron has been very efficacious as an astringent in chronic diarrhoea and dysentery, in that known as the army diarrhoea. These diseases, as they occur in civil practice, may sometimes be arrested by this agent, but not usually, in the author's experience. A solution of the tincture of iron is one of the numerous remedies used to destroy the ascarides vermiculares—the thread-worms which infest the rectum. As the development of these parasites is favored by the anaemic state, it is good practice to conjoin with any local treatment the internal use of iron, notably the sirup of the iodide.

Iron is frequently given with advantage to promote appetite and digestion merely. Indeed, it is the opinion of some eminent authorities that the chief use of iron as a remedy, even in anaemia, is to promote the digestive function. For the purpose of increasing appetite and energizing digestion, the sulphate is the best chalybeate, unless, indeed, the mucous membrane prove intolerant. When digestion is feeble, and the intestinal movements sluggish, it is often advantageous to combine aloes with iron, as in the official aloes-and-iron pill, or with sulphate of magnesia, as in the mistura ferri laxans, the formula for which has been given.

The condition most usually requiring iron is anaemia, a deficiency not only of the haematin but of the red corpuscles. Iron is given in this state with the view of supplying to the organism a material in which it is deficient, and in this way promoting the construction of the red globules. As, however, food, especially beef, is rich in iron, and as but a small amount of that administered is really assimilated, there is much reason for holding that at least an important function of iron in anaemia consists in its power to promote appetite and digestion. Practical physicians are familiar with the fact that iron improves but little, if at all, the condition of the anaemic, when it does not increase the desire for food and the ability to digest it. In anaemia, iron is given with two objects: to furnish a needed material to the blood; to increase the energy of the primary assimilation. To accomplish the first object, small doses—one or two grains—of reduced iron or of the carbonates, or some one of the combinations with vegetable acids, are most suitable. The second object is best attained by the more active astringent preparations, especially the sulphate and the chloride. Large doses of these are frequently well borne. When they disagree, other salts may be tried, but preference should be given to the most astringent preparation which the patient's stomach will tolerate. 12 In chlorosis, the good effects of iron are not so conspicuous as in anaemia, although they are allied states. During a course of iron in chlorosis, purgatives are now and then necessary. Better results are obtained from a combination of iron and arsenic, and iron and strychnine, than from iron alone. The arseniate of iron is an excellent remedy in chlorosis, but it must be given in larger doses than the po3ological tables authorize, for it is by no means so actively toxic as is commonly supposed. A good formula is the following: Rx Ferri arseniat., gr. ij ; ext. cinchonae, gr. xij. M. Ft. pil. no. xij. Sig. : One three times a day after meals.

In anaemia and chlorosis, the iron should be taken after meals to be mixed with the food. The preparations of iron should not be continued too long; occasional intermissions in their use are necessary, otherwise the digestive organs become deranged, and the good effects are lost. Occasional purgation is useful, and acts in a way to favor the absorption and assimilation of the iron. Air and exercise should always, if practicable, be prescribed in a ferruginous course, for the assimilation of iron is directly favored by these hygienic influences.

The anaemia of chronic malarial poisoning is especially improved by iron. If enlargement of the spleen and engorgement of the portal circulation co-exist, the use of the compound jalap-powder should precede the iron; or the latter may be combined advantageously with resin of podophyllin, as follows: Rx Quininae sulphat., 3 j ; resinae podophylli, gr. iv; ferri sulphatis exsic, Эj. M. Ft. pil. no. xx. Sig.: One or two pills three times a day.

According to some, massa ferri carbonatis is preferable to the sulphate; it is certainly sometimes better borne. Rx Mas. ferri carbonatis, 3 j ; acidi arseniosi, gr. j ; quininae sulph., Э ij. M. Ft. pil. no. xl. Sig. : Two pills three times a day. In enlarged spleen of malarial origin, a combination of sulphate of iron with sulphate of quinine is generally preferred. Rx Quininae sulphat., 3 ij ; ferri sulphat. exsic, 3 ss. M. Ft. pil. no. xxx. Sig.: One pill three times a day, or four or five during the day.

Although the preparations of iron are of little service in leucocy-thaemia, they are certainly in a high degree useful in pseudo-leucocy-thaemia, or cachexia of the spleen. In the latter disease the relative number of blood-corpuscles may be greatly reduced, but they can be increased in number and raised to the normal by the use of those materials needed by the blood-making organs, especially by the use of iron.

In syphilitic cachexia, the preparations of the iodide of iron possess a high degree of utility. In sloughing phagedena, or simple chancroid, the iodide is frequently prescribed when these accidents occur in debilitated constitutions. Some authorities prefer the tartrate of iron under these circumstances, but the iodide acts with more promptness and vigor. In the treatment of constitutional syphilis, the ferruginous preparations are only useful in so far as they may be applied to promote constructive metamorphosis. More commonly than is supposed by the advocates of special plans of treatment, tonic remedies, especially chalybeates, exercise a most favorable influence over the course and duration of syphilis. Rx Iodoformi, Э j ; hydrargyri chloridi corrosiv., gr. j ; ferri redacti, Эj. M. Ft. pil. no. xx. Sig.: One pill three times a day. Rx Iodoformi, chinoidin., ferri redacti, ậậ Э j. M. Ft. pil. no. xx. Sig.: One pill three times a day.

Iron is one of the remedies most useful in the treatment of acute rheumatism. As was originally suggested by Reynolds, the tincture of the chloride is most serviceable. It is more especially adapted to the treatment of pale, delicate, and cachectic subjects, and is much less beneficial, if not positively harmful, in the plethoric and overfed. Given in suitable cases, the tincture of iron, in doses of τη xx- xxx every four hours, diminishes the pain, fever, and sweats, lessens the chances of cardiac mischief, and hastens convalescence. By retarding waste and favoring excretion of uric acid through the kidneys, the duration of the disease is shortened and a tedious convalescence is prevented. We owe to Dr. Anstie the important suggestion that tincture of chloride of iron may be used successfully as a prophylactic against acute rheumatism. Here, again, the author must state, as a result of his personal observation, that such prophylactic treatment is very useful in weak and cachectic subjects and not applicable to the robust and full-blooded. The tincture of iron should be administered without delay in such weak subjects with a rheumatic history, when they complain of lassitude, muscular pains, sore joints, furred tongue, although they are yet free from fever and joint-swellings.