Such careful pharmacologists as Bunge, Schmiedeberg, and Hamburger claimed that inorganic preparations of iron are neither absorbed nor assimilated, maintaining that the blood and hemoglobin are influenced only by the organic compounds. Yet, notwithstanding these statements, clinical experience has fully demonstrated the value of such preparations as reduced iron, tincture of the chloride, carbonate, etc.; and it is still perhaps a mooted question whether appreciable amounts of them are actually absorbed, or whether, according to Bunge, the inorganic prevent the decomposition of the organic salts of iron in the food by fixing the decomposing agents in the intestines. At all events, the beneficial results in anemia and chlorosis of large doses of the inorganic preparations are too manifest to justify abandonment of these agents because of our ignorance touching their modus operandi.

At the present time it is fairly well conceded that Bunge was wrong in his general hypothesis, and the recent work of many pharmacologists has shown that most of the ordinary preparations are capable of absorption in the intestine, and it is also probable that iron takes part in a number of synthetic combinations in the liver, some of which may be ultilized in normal metabolism, while others are cast off in the bile and thus re-enter the intestinal canal.

The amount of urea is increased and micturition rendered more frequent by preparations of this metal.

Elimination takes place chiefly by the feces, to which a blackish color is imparted by the formation of ferrous sulphide. The bile, urine, and even the skin, as well as the mucous and serous membranes, share in the excretory process.

Untoward Action. - The continued use of ferruginous preparations has a tendency to impair the normal digestive powers, occasioning even gastric oppression, nausea, and vomiting. Reduced iron, the phosphate, and the pyrophosphate produce less untoward action than other preparations, and the ferrous are better tolerated than the ferric salts. Not infrequently acne of the face, breast, and back is occasioned, while the prolonged administration of the drug may in rare cases be accompanied by hemorrhages from the mucous membranes and symptoms of plethora and vascular excitement. Large doses of the ferrous sulphate may occasion obstruction of the bowels. In some rare instances irritation of the kidneys may be induced, and again iron is often badly tolerated in gouty conditions.

Poisoning. - The ferric preparations in a concentrated form produce all the symptoms of an irritant poison - gastric pain, vomiting, etc.

Treatment of Poisoning. - The stomach should be emptied by an emetic or carefully cleansed, the treatment being followed by the administration of alkali solutions, tannic acid, and demulcent drinks, the procedure being similar to that employed in poisoning from mineral acids.

Therapeutics. - Externally and Locally. - The astringent and styptic properties of chlorides and sulphates of iron have rendered them serviceable in controlling hemorrhage and as local astringents in relaxed conditions of the pharynx and larynx and mucous membranes generally. The tincture of the chloride has been highly-recommended as a local application to the throat in diphtheria, and chronic and indolent ulcers may often be benefited by a wash containing from 2 to 5 grains (0. 12-0.3 Gm.) of the sulphate to I ounce (30.0 Cc.) of water. In subacute pharyngitis and in tonsillitis tincture of the chloride with glycerine, simple syrup, and chlorate of potash makes an effective mixture.

It is important to remember that it is bad surgery to use the astringent salts of iron in deep wounds or even in superficial ones. Pressure will usually fulfil all the indications of an astringent.

Iron baths are probably of little service.

Internally. - The most important use of iron is to restore the number of red corpuscles and the amount of hemoglobin. In both the primary and secondary anemias iron is useful. In chlorosis, especially, it is of great value; but in order that its effects may be most beneficial, cathartics, such as rhubarb and aloes, which do not irritate the intestines, should accompany its use. In the many types of secondary anemia iron is of paramount value. It is used therefore following hemorrhage, acute infections as, erysipelas, scarlet fever, puerperal fever, diphtheria, measles, influenza, typhoid, tuberculosis, syphilis, etc.

In many constitutional disturbances associated with malnutrition iron is of service. Thus in the neuralgias, particularly if secondary anemia is a concomitant cause, in menstrual disorders, in neurasthenia, in the anemia of the opium or cocaine habitue; in the anemias due to chronic toxemia of Bright's disease it is invaluable; particularly as Basham's mixture.

Contraindications. - Iron is contraindicated in conditions of stomach irritability, as is seen in febrile disturbances and in chronic disorders of that viscus. As a rule, the drug is not well tolerated in acute inflammatory conditions, malignant disease, and in the hemorrhagic diathesis.

Administration. - If the appetite be poor, iron should be administered in small doses (invariably after meals) or preceded by vegetable bitters. The tincture of the chloride and the stronger preparations should be freely diluted with water. The citrate of iron is a mild preparation well adapted for children and persons of delicate stomach.

Probably the salt richest in iron, yet of all the ferruginous preparations the most agreeable and least irritating, is the iron and potassium tartrate. The soluble ferric pyrophosphate is also a mild and pleasant preparation. The compound iron mixture possesses special advantages in the treatment of chlorosis and chronic diseases of the skin, while the solution of iron and ammonium acetate (Basham's mixture) is the best preparation in albuminuria -particularly that accompanying tubular nephritis - it being agreeable and well tolerated.

The best styptic is the ferric subsulphate or its solution.

Dialyzed iron, being agreeable to the taste, was formerly a popular remedy.

Although it has been shown that Bunge's theory of the inability of the body to utilize inorganic salts of iron is untrue, yet many of the newer proteid combinations serve very acceptably in modern therapeutics, especially in those rare cases in which marked idipsyncrasies to the effects of iron exist. Apart from such, however, there is, we believe, little justification, from an economic point at least, in the use of the numerous patented alcoholic combinations of iron salts.