0.1 Gm. metallic iron is contained in:— DOSE ix GRAMS Ferrum hydrogenio reductum 0.1 Ferrum lactieum 0.5 Ferrum pyrophosph. c. ammon. citr 0.55 Ferrum carb. saccharat 1.0 ferri acct. acth. (Klaproth) 2.6 Tr. ferri chlorat 2.S Ferrum oxyd. saccharat solub '3.6 Iron tropon 4.0 Iron somatose 5.0 fern chlorati aether (Bestuseheb 10.0 Syr. ferri iodidi 11.0 Tr. fern poinftti 12.0-16.0 Liq. ferro-mangani sacch. u. pept. (Ilelffenberg). 16.6 ferri album 25.0 Malt extract Ivith iron (TAflund, ferr. pyrophosph. c. amnion. citr. 27i.) 27.5 'Fr. ferri comp 50.0 Malt extract with iron (Scherinq, ferr. oxyd. sacch. soluli. 3 120.0 Pil. 131a-udii (0.02 Fe) 5 pil.
Pil. alo6t. ferrat. (0.03 Fe) 3-4 pil.
The tables show the frequently slight percentage of the higher constituted iron compositions which often probably does not exceed that of the blood (and therefore also of the blood sausage). The conditions, however, are favorable to resorption, and all these preparations have been successfully used. The table also shows the doses. Aside from the recipes mentioned on p. 139, older children may be given with ad vantage tr. ferri chlorati nether., three times daily 10-15 drops, and 1 or 2 Blaud's pills three times daily.
The subcutaneous injection (in the adult a 5 per cent. solution of ferrum citricum oxyd., 0.05-0.1 c.c. (niA-1;) into the nates; as recom mended by Glaevecke, and Quincke) will hardly find application in the child; it causes smarting at the point of injection for 24 hours; rectal in troduction (fcrr. citr. oxyd. 0.1-0.6 c.c. (lit in 50 c.c.(+ 1 oz.) starch solution, three times daily, after Jolasse) is likewise hardly indicated.
Some excellent authors attribute a special influence to chalybeate waters (Henoch, von Noorden, Senator); their importance lies proba bly to a certain extent in the very high attenuation of the iron (0.01 to not more than 0.1:1000), also in the fact of their holding CO, in solution and in the possibility of administering the same on an empty stomach. If it is used at the springs, there are of course many other influences to be considered.
The saline carbonated waters are said to have the best effect proba bly on account of their purgative effect in constipation. Of the non arsenious ones 1 pint is given (warmed, if desired) on an empty stomach in the morning, one pint and a half with the dinner, and the same quan tity six hours after the principal meal. For home use pyrophosphorated
iron water is more suitable because even with the greatest care in filling the bottles the iron is lost (Binz).
Should iron not have the desired effect, arsenic may be given to advantage, especially in weak-muscled children with enteroptosis. The closes are given on p. 140 and the admissible maximum close is 1 mgm. gr.) daily. Arsenious chalybeates are, of course, suitable in these cases.
Many physicians at the present time assist or replace iron medica tion by diaphoretic measures, prescribing a hot bath two or three times a week, followed by an hour's sweating, or else the use of the Phenix hot air apparatus (Grawitz, Rosin, Senator, Mandock). Raebiger has made two series of experiments, one exclusively with iron medication and one exclusively with diaphoreties. The success of the second series was as large as that of the first. It is not certain, however, whether this is due to the water economy of the system or to the general effect upon the metabolism. Cold hydriatic measures should be avoided, the remarks made in regard to school anemia (p. 135) applying to these cases like wise. On the other hand it is a very good plan to accustom the body to colder temperatures by the use of carbonic acid baths, of which 3 should be taken weekly (Senator and Frankenhauser); also the effect of so called mineral baths is probably based upon their containing the iron they hold not being resorbed by the skin.
In regard to other dietetic methods, nutrition, good nursing, dura tion of sleep, gymnastic exercises (respiration), sport and games, the same remarks apply which were made in regard to school antenna, also the remarks in regard to the treatment of complications. Chilblains are favorably influenced by long bathing of the extremities in hot water with a little alum, painting with ichthyol collodion (10 per cent.), inunc tion with camphoric 5.0 c.c. (1 dr.) vaselini ad 50.0 c.c. (10 dr.). The discharge oozing from the vagina is hardly debilitating as is gen erally supposed; in these cases as well as in menstrual troubles, local treatment should be warned against (aspirin, antipyrin).