The treatment of erysipelas by large doses (τη x— 3 j every four hours) of tincture of chloride of iron is now very generally adopted. It is questionable whether this practice is directly beneficial. Its utility depends chiefly on the support which it affords to the organism while laboring under a debilitating disease, and, as an abundant supply of aliment is prescribed with the iron, it is impossible to estimate in any given case how far the result may be attributable to the remedy.

Influenced by the same considerations, the tincture of iron is frequently prescribed in diphtheria, alone or in combination with chlorate of potassa. Although it possesses no special utility in this disease, it may serve as one of the means for maintaining the forces of the body, and in this way indirectly contribute to a favorable result. There is no advantage in applying the tincture of iron to the fauces in diphtheria; it is not a solvent of the false membrane, and can not prevent the spread of the exudation; it is, however, now freely used, and it is said with good results.

In the treatment of scrofula, strumous enlargement of the cervical, inguinal, and mesenteric glands, and in rickets, the preparations of iron occupy a most important place. In these affections the sirup of the iodide of iron is generally preferred, and excellent results are obtained from a combination of phosphate of iron and phosphate of lime, especially in rickets. In these cases, also, the sirup of the iodides of iron and manganese is indicated. Iron is one of the remedies most frequently prescribed in chronic tuberculosis, but it has no special influence over the deposition of tubercle. It helps to a better state of the blood-making process, and, by promoting the constructive metamorphosis, hinders the progress of the malady.

As neuralgia so often depends on anaemia, it happens that iron is one of the most frequently prescribed remedies for this disease. Anstie prefers large doses {τη xxx—xl ter die) of the tincture of the chloride, and twenty-grain doses of the saccharated carbonate twice or three times a day.

In disorders of the mind, either dependent on or increased by an anaemic state, iron is often useful. In chronic mania and melancholia, when debility is present, iron is employed as a restorative agent. The ferruginous preparations are especially useful in the anaemic forms of puerperal mania, and in the insanity of lactation. Bucknill and Tuke prefer the tincture of the chloride in these affections.

Iron has been much used in the epilepsy of weak and anaemic subjects, but it seems to the author to be more hurtful than beneficial, as a rule, yet he has seen excellent results from a combination of bromide of iron and bromide of potassium in such cases: Rx Potassii bromidi, oz j ; ferri bromidi, gr. iv; aquae, oz ij; syrup, simplicis, oz vj. M. Sig.: A tablespoonful bis die.

Large doses of subcarbonate of iron have long been used with advantage in chorea. When the subject of this disease is distinctly anaemic, iron, in some of its forms, is unquestionably serviceable, and its utility is often increased by combination with purgatives. When anaemia is not present, arsenic is preferable to iron. Chorea arising from moral causes (anger, fright, etc.), and from pregnancy, is not benefited by iron. This remedy is especially adapted to the chorea of anaemic girls about the age of puberty.

The preparations of iron are of course inadmissible in acute affections of the respiratory organs, but, in certain of the chronic forms and stages of these diseases, some of the chalybeates are very useful. In chronic bronchitis, with free expectoration, the mistura ferri com-posita has long been used with advantage. At the present time the phosphate of iron, quinine, and strychnine, is generally preferred in chronic bronchitis, in the chronic forms of phthisis, in emphysema, and in humid asthma. Iron is contraindicated when pulmonary haemorrhage exists or is threatened. A combination of tincture of digitalis and tincture of chloride of iron abates the temperature and diminishes the sweats of hectic fever. Rx Tinct. digitalis, 3 iij ; tinct. ferri chloridi, 3 v. M. Sig.: Fifteen drops three or four times a day.

In fatty degeneration of the heart, the preparations of iron render important service, by improving the nutrition of the organ. The palpitations, the murmur, and praecordial anxiety which accompany cases of anaemia and chlorosis, are relieved by chalybeate medicines. In dilatation of the cavities of the heart, especially the right, accompanied by cough, difficult breathing, and general dropsy, greater relief is sometimes experienced from the preparations of iron than by the so-called cardiac sedatives and diuretics. In these cases, as also in mitral regurgitation, the distress of the patient increases with increasing thinness of the blood, and is diminished by those remedies, such as iron, which improve the quality of the blood. A combination of iron, digitalis, and squill, is sometimes extremely serviceable in these cases—for example: Rx Ferri redacti, quininae sulphat., pulv. digitalis (English), ậậ Э j; pulv. scillae, gr. x. M. Ft. pil. no. xx. Sig.: One pill three or four times a day. Iron may be used with advantage to assist in the process of compensation in valvular lesions, when the condition is one of anaemia. Iron is contraindicated in all cases of cardiac disease occurring in those who are full-blooded.

In the passive forms of haemorrhage in purpura, the hemorrhagic diathesis, epistaxis, gastric, intestinal, and renal haemorrhage, when they are due to anaemia or favored by it—iron is unquestionably useful, and the preparation most generally applicable is the tincture of the chloride.

Derangements of the menstrual function, when associated with anaemia, more especially when produced by anaemia, are often removed by the use of chalybeate medicines. Amenorrhea is, more frequently than to any other cause, due to anaemia of the ovaries, consecutive to chlorosis or general anaemia, and dysmenorrhea may depend, in one of its forms at least, upon the same condition of the blood. Menorrhagia may also be one of the results of an impoverished state of the blood. Iron is the most appropriate medicament in these disorders. It is the judgment of Graily Hewitt and Barnes that "small doses of iron are generally the best" in amenorrhoea. Barnes prefers the solution of the acetate, and speaks favorably of the citrate of iron and ammonia, given in an effervescent state, and of the combination of iron and strychnine. The use of ferruginous preparations in menstrual disorders should be determined by the results of a careful differentiation of the causes. The absence of the uterus and ovaries, occlusion of the cervix, and various other conditions besides anaemia, should be eliminated, and the use of iron restricted to those cases in which an impoverished state of the blood is either the only factor or an influential one.

The injection of the various styptic solutions of iron into the uterine cavity, to arrest postpartum hemorrhage, is now common practice. Notwithstanding the alleged innocuousness of this treatment, it is probable, as Snow Beck has shown, that fatal results have ensued from the incautious use of these injections. The official solutions of the perchloride and subsulphate have been thrown into the uterine cavity, with the effect to cause uterine thrombosis, followed by systemic infection. These solutions are much too strong; one part of Monsel's solution to three of water is sufficiently styptic, and is probably perfectly safe. The uterine cavity should be cleared of clots, and the nozzle of the syringe carried well up to the fundus, when the injection should be slowly delivered. The reader need hardly be reminded that this expedient is only proper after the usual means for securing uterine contractions have failed. The same plan of styptic injections has been used to arrest the haemorrhage from abortion, but caution is necessary in these cases, for it is essential to safety that there be an open and patulous condition of the os, to permit escape of coagula. Similarly these injections are used to restrain bleeding in cases of uterine fibroids, uterine cancer, and in the uterine haemorrhage dependent on spongy granulation of the mucous membrane. In every case of such use of styptic iron injections, it is essential, first, that air be not pumped into the uterine cavity, and second, that sufficient dilatation of the cervical canal exist to permit ready exit to the surplus fluid and coagula.

In albuminuria, connected with chronic changes of the kidney, iron is often very serviceable to improve the digestion, and to correct the anaemia, which is such an obvious feature of these maladies. The tincture of the chloride and the tincture of the acetate—especially the latter—are preferred, partly on account of their value as haematinic remedies, and partly because of their supposed diuretic action. When spermatorrhea is dependent upon an impoverished condition of the blood, with relaxation of the vesiculae seminales, the tincture of iron is useful, but it is rarely of itself sufficient to effect a cure. The chalybeates are only harmful in those cases of nocturnal seminal losses which in the robust are merely significant of plethora. In gleet occurring in anaemic subjects, and in the prostorrhoea and catarrh of the urethra which arise from relaxation, the preparations of iron are useful adjuncts to other measures. Rx Tinct. ferri chloridi, 3 vj ; tinct. cantharidis, 3 ij. M. Sig.: Fifteen drops in water, three times a day.

The sirup of iodide of iron is one of the most successful remedies in the nocturnal incontinence of urine in children. The precise indications for its use are not evident. Sometimes belladonna succeeds better. It appears to the author that the iodide of iron is more useful in the case of pale, delicate, and strumous children, and belladonna in those who are more robust, the condition in the former being one of atony of the muscular wall of the bladder, in the other too ready contraction from the reflex stimulation of acid urine. In these cases of incontinence of urine the sirup of the iodide should be given in doses of fifteen to twenty minims, well diluted with water, three times a day.

Local Uses

The styptic preparations of iron are frequently used to restrain haemorrhage. Leech-bites that bleed too profusely, haemorrhage after extraction of teeth or in minor surgical operations, oozing from a large wounded surface, may often be checked by the use of Monsel's solution.

As a topical application in gonorrhoea after the acute symptoms have subsided, in mucous cervicitis, in leucorrhoea, the styptic preparations of iron are certainly useful, but a strong objection to their use arises from the staining of the clothing.

Monsel's solution is an effective application to fissured nipples: Rx Liquor ferri subsulphatis, 3 ij ; glycerini, 3 vj. M. Sig. : Apply with a camel's-hair brush to affected parts. Pure solution of subsulphate of iron will arrest the growth and cause the exfoliation of syphilitic vegetations of the glans and prepuce.