A. Acne, 15, 340; 17, 61

C. Acne (Millet and Startin); ecthyma (Brown); eczema (Devergie); zoster (Betz); scleroderma (Arning); erythema nodosum, 17, 78. In chronic eruptions with bluish or violet margins and thin, ichorous discharge, 32, 1: 395.

Remarks

Iron is a drug which is as important in dermatology as in any other department of therapeutics. As a haematogenic it occupies the first place in the minds of most; and by some is regarded as almost the sole agent that can be depended on to increase the proportion of red corpuscles and improve the quality of the circulating fluid. It is therefore given on the slightest provocation by many physicians whenever they fancy that the blood needs enriching in this particular respect; in fact, many seem to regard it in the light of a food rather than a medicine, and prescribe it in large quantities and for long periods of time. I believe that this view is an erroneous one, and when acted on in practice often leads to results the reverse of beneficial. Careful experiment has shown that both mercury and arsenic possess the power, when properly admin-istered, of increasing the proportion of red corpuscles, but one would hardly feel justified on that account in prescribing them in the same lavish manner.

But iron is a normal ingredient of the body and of the blood, and therefore may be regarded as a food, say some, and may be given in almost unlimited quantity, under the assurance that the blood will only appropriate so much as it needs, and that the excess will pass off without effect. This is pun theory, and is not justifn 1, 1 think, by the facts. As well might any of the other ingredients of the red corpuscles be selected, and administered in like excess. Form a therapeutic point of view iron should not be regarded as purely a food, but as a medicine, capable of accomplishing much good, when properly employed, but pregnant of evil when abused. With this caution it may be stated that the indica-tions for the use of iron are the same in diseases of the skin as in other diseases sot and that the general condition, not the particular lesion, is to in-fluence the choice of this drug. Physiological chemists, when referring to the subject of iron in the blood, speak of it in its elementary form, and not as an oxide, a chloride, a sulphate, or any other combination. It has seemed to me, therefore, far more rational to supply it in its simple form, and not as a salt that nature must decompose in order to get at the base, which is utilised as such, or perhaps united with other substances in forms not yet fully known to us. The evident preference for the proto- rather than the per-salts of iron, that is exhibited of late years by many experienced practitioners, is a step in the same and in the right direction. My own practice for some years has been, when iron simply was demanded, to give it in its simplest form, namely, the Ferrum Redactum of the pharmacopoeia, which may be prescribed in pill form or in trituration, one grain of the pure iron being the usual maximum daily dose. If, in addition to the iron, it appears expedient to give other drugs, as sulphur or sulphuric acid, I prescribe the sulphur mixed, but not combined with the iron, and the sulphuric acid in a different potion, and not the sulphate of iron. Either the sulphur or the sulphuric acid are needed or they are not needed. If the latter, why give them? If they are needed, surely the quantity contained in the ordinary dose of sulphate of iron must appear rather small when compared with the doses of sulphur or sulphuric acid that are usually prescribed when given without the iron. So with many of the other preparations of this metal. This, however, does not exclude the appropriate use of certain salts of iron in particular conditions in which experience has shown them to be specially useful, as the chloride of iron in erysipelas, etc. The officinal preparations of iron are: Ferrum Redactum; Ferri Chloridum; Ferri Citras; Ferri et Am-monii Citras; Ferri et Quinioe Citras; Ferri et Strychniae Citras; Ferri et Ammonii Tartrus; Ferri et Potassii Tartras; Ferri Ferrocyanidum; Ferri Lactus; Ferri Oxalas; Ferri Phosphas; Ferri Pyrophosphas; Ferri Subcarbonas; Ferri Sulphas; Ferri Sulphas Exsiccata; Ferri et Ammonii Sulphas; Liquor Ferri Chloridum; Liquor Ferri Citratis;

Liquor Ferri Nitratis; Liquor Ferri Subsulphatis; Mistura Ferri Com-posita; Pilula Ferri Carbonatis; Piluloe Ferri Compositoe; Piluloe Ferri Iodidi; Syrupus Ferri Iodidi; Tinctura Ferri Chloridi; Trochisci Ferri Subcarbonatis; Emplastrum Ferri. In addition there is a host of unoffi-cinal preparations, chemical and galenical and proprietary.